Physical therapists have responded to the high costs of physical therapy for CP/CPPS (often not covered by insurance) by helping patients learn to massage their own pelvic floor muscle trigger points with internal massage tools. Now, there's evidence that this at-home, self-treatment approach works.
Washington-Some 60% of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) could get significant relief from physical therapy because they have muscle tenderness as part of their phenotype. Yet the therapy is costly, and well-trained physical therapists are scarce. An instrument that allows patients to work out internal muscle trigger points at home could help remove those barriers.
Many clinicians who specialize in treating the urologic pelvic pain syndromes have seen the value of physical therapy of the pelvic floor for their patients' pain, and the approach has proven its mettle in a clinical trial of interstitial cystitis patients, results of which were presented at the 2010 AUA annual meeting.
But regular physical therapy, which is often not covered by insurance, can be out of financial reach for many sufferers. Physical therapists have responded by helping patients learn to massage their own pelvic floor muscle trigger points with internal massage tools. Now, there's evidence that this at-home, self-treatment approach works.
The men in the study worked closely with a physical therapist who mapped their trigger points and trained them to use the hook-shaped rigid wand, made of Ultem plastic, to massage these muscle trigger points internally. The wand integrates an algometer that measures applied point pressure to prevent patients from using excessive or dangerous force. The device, which is currently being reviewed by the FDA, will require a prescription and training by a certified physical therapist.
Patients used the wand two to three times per week for 5 to 10 minutes and were followed up at 1 and 6 months. Ninety-five percent (106/111) reported the therapy was very or moderately effective in relieving pain. Their average assessments of pelvic floor sensitivity to touch on a scale of 1 to 10 dropped from 7.5 at baseline to 4 at 6 months; 39% of patients reported a greater than 50% reduction in pelvic muscle sensitivity.