PT role and paradoxical relaxation by Dr Wise

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PT role and paradoxical relaxation by Dr Wise

Postby michaelm » Mon Sep 17, 2012 4:22 pm

Hello Friends,
It looks like I may have symptoms of PN- pain and burning in buttocks on sitting, also foreign body sensation in rectal area, numb feeling in buttock etc- diagnosed with different conditions for past few years- lumbosacral radiculopathy, immune mediated neuropathy etc- lots of tests- including MRI of pelvis -nothing conclusive, then I started reading about PN and looks like my symptoms closely mimic it. Started seeing PT trained in pelvic floor and found very tight pelvic floor muscles and started doing manual therapy, trigger point release etc for 3- 4 sessions. Also met with a yoga instructor who got better after alignment based yoga for the same problem. I know ,it is said yoga is contraindicated so very confusing. My PT says that the muscles need to be stretched so the the nerve can start gliding. She advised squatting, stretching poses to make muscles stretch etc. She appears to be very knowledgable about PN which she thinks most likely is from tight pelvis. I don't have any history of trauma but may be prolonged sitting at work and weights. I do have appt with Dr SA for formal evaluation and he has scheduled me for possible injection the next day.

I want to know if people have benefitted from PT or not and also with Dr Wise protocol of paradoxical relaxation? Should I wait for any injections to see if PT has any beneficial effects? Has anybody seen Staphnie Pendergrast- PT in CA for this?
Any advice will be greatly appreciated as I have been suffering from this pain and burning for past 2 years.
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Re: PT role and paradoxical relaxation by Dr Wise

Postby HerMajesty » Thu Apr 04, 2013 4:21 pm

A PT evaluation seems very reasonable before any invasive procedure. a nerve bock tends to have diagnostic value but only rarely has long term therapeutic value; and occasionally it has long term adverse effects. You should search this site for references to "Dr." Wise (David Wise uses the title "Dr." because he has a PhD, not because he is a medical doctor, or because he holds a doctorate in PT, Chiro, or anything else which qualifies him for medical practice). You will find posts from several people who participated in the Wise-Anderson protocol course and feel that they were seriously scammed, out of thousands of dollars and years of their lives. (Please note that I said people FEEL they have been scammed, which is subjective. I cannot tell you whether or not Wise-Anderson is objectively a scam; you will have to use your own discernment). I recommend using a PT who charges per single session such as those listed on the "find a PT" section of this site.
Last edited by HerMajesty on Wed Jun 26, 2013 1:58 pm, edited 1 time in total.
pelvic pain started 1985 age 14 interstitial cystitis. Refused medical care from age 17, did GREAT with self care for years.
2004 PN started gradually, disabled by 2009. Underlying cause SIJD & Tarlov cysts
improved with PT & meds: neurontin, valium, nortriptyline, propanolol. (off nortriptyline & propanolol now, yay!)
Tarlov cyst surgery with Dr. Frank Feigenbaum March 20, 2012.
Results have been excellent so far; but I won't know my final functional level for a couple of years.
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Re: PT role and paradoxical relaxation by Dr Wise

Postby helenlegs 11 » Fri Apr 05, 2013 2:13 am

Yes Michael, agree with HM, get a good pelvic PT, especially if you have tight pelvic floor muscles. Stephanie is one of the best for this type of work although I think there will be many people who have similar abilities as she has done many training workshops. I also think that alignment based yoga could help too if the problem has a postural element to it. I have recently posted about standing and walking properly, sounds silly but I have realised that I don't always do this and need to walk using my glutes rather that lifting my leg.
If some of the Yoga is too much, don't do it, but I'm sure a lot of it will be of benefit. I quite like yoga but have overdone it sometimes but can always get back to base line pain after a while, so nothing is irreversible, at least with me.
If your problem is due to tight pelvic muscles, physiotherapy should help enormously, although it may take some time.Did you feel any benefit from the sessions you did have? Hope you get some good answers and explanation for your pain from your forthcoming Dr appointment. Let us know what he says :)
Good luck.
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
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Re: PT role and paradoxical relaxation by Dr Wise

Postby Selbourne » Sat Jun 22, 2013 12:17 am

HerMajesty wrote:You will find posts from several people who participated in the Wise-Anderson protocol course and feel that they were seriously scammed, out of thousands of dollars and years of their lives. It you are going to give PT a try, stick with real PT.


And that's a terribly unfair summation of the Wise-Anderson Protocol (WAP), which has been extensively studied and published in the best peer-reviewed journals (e.g. Journal of Urology). You can see the various published papers in full here: Wise-Anderson Protocol papers

Also available on the 'net (although not at this PNE-focused forum) are many successful case histories of people who benefited from the WAP. Just Google "wise anderson protocol success rate" or look at threads like this: http://www.mdjunction.com/forums/prosta ... n-protocol

Readers should note that the WAP only has a success rate of around 70%, so there are going to be a good few people who are not helped by it. And yes, some of those people are going to end up at forums like this, bitterly denouncing it. But they went in with their eyes open, and knew there were no guarantees, so why are they whining now? Ironically, it appears that the very thing that drives them to spew bile about the WAP may be the same thing that made them fail to follow the protocol's paradoxical relaxation aspect in the first place (and thus fail to improve) — a combative, hypervigilant disposition.

Lastly, the WAP is not suitable for treating pudendal nerve entrapment. If you truly have the rare entity of PNE, then you need other forms of treatment. More details:
http://en.wikipedia.org/wiki/Pudendal_nerve_entrapment
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Re: PT role and paradoxical relaxation by Dr Wise

Postby Violet M » Sun Jun 23, 2013 12:34 am

Selbourne wrote:
Also available on the 'net (although not at this PNE-focused forum) are many successful case histories of people who benefited from the WAP.


Hello Selbourne,

The moderators of this forum do not censor people from politely posting WAP success stories. Anyone who has had success from it is welcome to post here. Do you have a success story of your own that you would like to post?

I guess it makes sense that we are a PNE focused forum. It is, after-all, the mission of HOPE -- to provide support to people with PN or PNE. Other people with related illnesses (including pelvic floor dysfunction) are welcome to post here but we make no apologies for being a PNE focused forum.

Best,

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: PT role and paradoxical relaxation by Dr Wise

Postby Selbourne » Sun Jun 23, 2013 1:02 am

Hello Violet

My success story, and those of others, are posted here:
http://www.chronicprostatitis.com/forum ... um.php?f=5

I did not mean to denigrate this forum by calling it a "PNE-focused forum". That's what it is, and so it should be. I just think it's not a good place to discuss and criticize treatments for unrelated disorders, like male chronic pelvic pain syndrome. Some of the people who posted claims here of "scamming" and "wasting years of their lives" do not have PNE and are simply using this forum as a platform to throw mud at people who treated them, because they did not get better (despite knowing that there is a 30% failure rate). All forms of treatment, for all conditions, have a failure rate! The PNE surgery failure rate is HUGE (over 50%), and those counted as "successes" are often still using pain medication years later.

What I'm trying to say here is that there are some things to be avoided:
  • Deciding that you have a condition like PNE, which the medical literature describes as "rare", and then sticking to that (perhaps mistaken) idea through thick and thin;
  • Attacking treatments for other conditions simply because at the back of your mind you suspect you yourself should have tried the treatment before embarking on a quest to get PNE surgery;
  • Hosting a forum that acts as a platform for disaffected patients, with other conditions, who were not helped by one treatment or another. It's okay to say "I tried the Wise-Anderson protocol (aka the Stanford Protocol) and it did not help me". But it's not okay to post screeds of libel claiming criminal malfeasance by the clinician involved, just because you are pissed off you didn't get better!

If I'm not being clear, just tell me and I'll try to rephrase. Thanks...
Last edited by Selbourne on Sun Jun 23, 2013 1:53 am, edited 1 time in total.
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Re: PT role and paradoxical relaxation by Dr Wise

Postby Violet M » Sun Jun 23, 2013 1:50 am

I agree with you Selbourne that it would be fair to ask Hermajesty to take the words "scam" out of her post. HM, would you be kind enough to edit your post please? I'm sorry, I should have noticed that sooner and asked that the post be edited.

Selbourne, please edit your post to remove the entire paragraph containing a disparaging personal attack and then I think we can return to a pleasant conversation.

Since PN/PNE often may coexist with male pelvic pain it's probably impossible to completely separate the two and restrict discussions of one to your forum and the other to this forum.

I agree with you that no one should stick to a diagnosis of PN/PNE through thick and thin.

Where are you getting your statistics for a failure rate for PNE surgery being huge(over 50%)? The published literature has the success rate between 67 and 86% with a small percentage getting worse from surgery. You can find the literature on our publications page from the homepage of the website. As someone who is off all pain meds and back to work sitting many hours a day I believe PNE surgery should remain in the list of options to consider although I do believe conservative treatments should be tried first.

Violet/Mod3
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: PT role and paradoxical relaxation by Dr Wise

Postby Selbourne » Sun Jun 23, 2013 2:01 am

Violet, I removed the paragraph about the other defunct PNE forum, but I think members here would have found it instructive, because there's a lesson in there somewhere, don't you think?

More than removing the word "scam" from Hermajesty's post, I would think removing all the threads about the WAP should be considered. Or at least heavily editing them to remove the absurd claims of "scam". Although Wise is not a medical doctor, he is part of a team that includes Dr Anderson, an expert academic urologist and Stanford Professor of Urology (you don't get better medical credentials than that!). And no, Dr Wise is also not a PT, but his team includes Tim Sawyer, an expert PT who is sought after by people from all over the world!

There's actually a thread at chronicprostatitis.com about the person who posted the "scam" claims here (and made the libelous Youtube videos about Dr Wise), and it's very enlightening, and a bit shocking. I'm not allowed to cut and paste it here, but if you email the site owner I'm sure he'll give you access.
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Re: PT role and paradoxical relaxation by Dr Wise

Postby Selbourne » Sun Jun 23, 2013 2:06 am

Surgery success rates
https://www.ncbi.nlm.nih.gov/pubmed/15716208

(8 out of 16 patients still improved after 4 years)
Last edited by Selbourne on Sun Jun 23, 2013 2:14 am, edited 1 time in total.
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Re: PT role and paradoxical relaxation by Dr Wise

Postby ezer » Sun Jun 23, 2013 2:12 am

The latest statistics published on the WAP show a median pain reduction from a 4 to a 3 (within a select group of participants) which is not exactly astonishing.
Even if you ascribe to a psychogenic origin for pelvic pain, the WAP is just not sufficient. More recently, people like Dr.Peter Levine or Dr. Robert Scaer have linked various pain problems to trauma and in particular to pre-verbal stage trauma. A complete psychogenic cure requires in-depth psychological work which is way beyond the scope of the WAP.
The PT as part of the WAP is also immensely confusing for sufferers. Patients get obsessed with those elusive trigger points that just keep coming back. It does not bring them closer to a cure.
Regarding your thread of WAP success stories, I personally know 2 of them that have relapsed since.
2002 PN pain started following a fall on a wet marble floor
2004 Headache in the pelvis clinic. Diagnosed with PNE by Drs. Jerome Weiss, Stephen Mann, and Rodney Anderson
2004-2007 PT, Botox, diagnosed with PNE by Dr. Sheldon Jordan
2010 MRN and 3T MRI showing PNE. Diagnosed with PNE by Dr. Aaron Filler. 2 failed PNE surgeries.
2011-2012 Horrific PN pain.
2013 Experimented with various Mind-body modalities
3/2014 Significantly better
11/2014 Cured. No pain whatsoever since
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