Chronic Pelvic Pain
Chronic pelvic pain is a syndrome that is being diagnosed with increasing frequency in both woman and men. It may begin as the result of endometriosis, gynecological infections or pelvic trauma from childbirth in women, and prostatitis or epididymitis in men. Urinary tract infections, interstitial cystitis, anal fissures and hemorrhoids, or trauma from surgery may lead to chronic pelvic pain. A fall on the coccyx, low back or abdominal strain may be a precipitating event and repetitive injuries from running, cycling and horseback riding may play a role.
Muscles and trigger points in pelvic pain
Even when musculoskeletal injury is not a direct cause of the pelvic pain syndrome, habitual tightening of abdominal and pelvic muscles is part of the defensive reaction of our “body armor” to stress and emotional trauma, and may eventually lead to dysfunction of the pelvic floor and surrounding muscles. This in turn can cause painful nerve entrapment, myofascial trigger points and referred pain, and though the initiating factors may have been repaired, the complex cycle of pain often cannot be broken until these secondary problems are resolved. The pain frequently interferes with sitting, driving, sexual activity and the overall enjoyment of life.
Multifaceted acupuncture treatment
Treatment for chronic pelvic pain is often fragmented and unsuccessful, and over time, patients are likely to become frustrated and demoralized. Traditional acupuncture may be of some help, but for lasting results, a multifaceted acupuncture approach that includes dry needling is often needed. As a family physician, I am acutely aware of the havoc that chronic pelvic pain can wreak on the lives of the individual with chronic pelvic pain and his or her family. I work closely with physical therapists, urologists and other practitioners in the San Francisco Bay Area and beyond who specialize in chronic pelvic pain.
I encourage you to learn more about Chronic Pelvic Pain in men and women through some of the many excellent resources available.
Working with Other Specialists
I believe it takes a village to raise a child, and a team to help recover from chronic pelvic pain. Since 2006, I have been collaborating with physicians and pelvic physical therapists from around the bay area and beyond, using “dry needling” (which I call “fine needle trigger point deactivation”) to release restricted areas that have not responded to other interventions, including acupuncture.
I am comfortable following the lead of whichever provider is coordinating the treatment, using dry needling/trigger point deactivation to release the specific areas they have recommended. Other providers, however, may not be fully aware that there are additional ways in which I can contribute to the team effort. A useful approach is to integrate trigger point needling into an overall myofascial acupuncture treatment that may include acupuncture, cupping or gua sha (a wonderful modality that targets fascial restriction,) and herbs or pharmaceuticals. This can be an opportune time to take advantage of some of the stress relieving of acupuncture. As a physician, I am also available for consultation or management of adjunct medical therapy with Western pharmaceutical and compounded topical medication.
I am available by phone or email to patients and providers discuss whether myofascial acupuncture can be of use to you or your patients. Though I perform my own evaluation before treatment, it is nevertheless important that the referring provider and patient provide adequate background information. Having information about previous evaluations, imaging and treatment allows me to take better care of my patients and use our time more effectively.