Pelvic Floor Muscle Spasm is one of the most common conditions leading to both in women and in men.
This condition is one of the “evil quadruplets” since it tends to co-exist with endometriosis, irritable syndrome. The condition is like having a charley horse in the muscles that surround the vagina, urethra, and . There are multiple reasons why this happens. / syndrome, and
Most often it is some other from endometriosis, , , or pelvic trauma may develop the , which unless treated, may last for many years. Some patients may also develop spasms after psychological trauma or even without any significant precipitating event. condition, that through complex neural mechanisms is irritating the (s). Patients who have
Most commonly patients with as well as any physical activity. Generally, this persists from hours to days after the or . It may also persist after urination or . Patients with spasms may also have trouble in starting the urine flow or difficulty in completely emptying the . Because of that incomplete emptying, they often get up at night multiple times to urinate. (s) will experience during intercourse, urination, and
physician or . Treatment consists of and relaxants. (s) may be easily identified during a physical exam or exam by a trained
The majority of patients are helped by those two modalities. In cases where is not relieved by and relaxants, botulinum toxin injections to the may be necessary. Treatment of the underlying is also very important.
In cases where developed because of other such as endometriosis, treatment of that underlying condition is very important. If someone has developed after placement of pelvic mesh, the mesh has to be addressed first before addressing .
At Arizona Center for (s). In most cases, we will be able to recommend a in your area or provide you with resources to find one. Strengthening through is critical. , we work with physical therapists in the Phoenix area and throughout the United States. We strongly believe that is the most important part of relieving
relaxants are usually used in the form of a vaginal or rectal suppository and seem to be more effective than oral medications. Different formulations of suppositories exist, and they will be discussed with you during the visit. Botulinum toxin A (BotoxÒ) injections are offered to patients when and suppositories fail. Those injections relieve spasms and in the great majority of patients, but they may need to be repeated every few months. Because those injections are painful, they should always be done under sedation.
If you have difficulty finding a International (pelvicpain.org), Women’s Section of American Society Association (aptapelvichealth.org), or Herman and Wallace Pelvic Rehabilitation Institute (hermanwallace.com) to find a provider in your area. in your area, please contact our office. We collaborate with therapists around the country, and we may be able to help you find one in your area. You can also visit the page of the
If you or someone you know is experiencing pain related to pelvic floor muscle spasm contact our office at 480 599-9682 or [email protected] to learn more about available treatments.
What to expect after BotoxÒ injection?
- BotoxÒ injections to pelvic floor muscles are almost always done in conjunction with pudendal nerve(s) block. The block is done to decrease pain after the procedure. When you wake up from the sedation after BotoxÒ injection, you will feel numbness in the pelvis, and you may have numbness in one or both of your legs. Numbness is completely normal and will disappear when the local anesthetic wears off.
- If you have numbness in your legs, you should avoid walking until the numbness goes away. You should have someone help you walk the first time you get up after the procedure.
- After the procedure, you may have difficulty emptying your bladder. Pelvic floor muscles are irritated immediately after the injection, and some patients may need a urinary catheter for a few days. Difficulty emptying the bladder goes away after BotoxÒ starts working and relaxes pelvic floor muscles.
- You may experience vaginal bleeding for 2-3 days after the procedure. It is completely normal, as long as the amount of bleeding is less than the menstrual period.
- After the local anesthetic wears off your pain may come back, and it may come back worse than it was before the procedure. This is because muscles are irritated from the injection. BotoxÒ starts working about one week after the procedure, but it may take 10-14 days to feel the relief of pain.
- It is very important to continue physical therapy after BotoxÒ Botulinum toxin by itself does not permanently cure muscle spasm, but it allows physical therapist to work more aggressively on your pelvic floor muscles.
- BotoxÒ wears off approximately 3-4 months after the injection. Some patients will not go back into spasm, but most will need a repeat injection. If you or your physical therapist feel your muscle spasm is returning, call our office to be scheduled for a repeat procedure.