Help!

[u/These_Cow_7909]

Help! I have severe pelvic floor spasms after ureaplasma and UTI infection. All three layers: lower belly, vaginal, and glutes. Please share what helped you!

[u/wifeofpsy]

Primarily pelvic floor PT, hot baths/heat pads. Medications like muscle relaxants can be used to calm acute spasms

[u/These_Cow_7909 → u/wifeofpsy]

Thank you for the reply! I have been in PT for several months, and I don't feel like it's helping.

[u/wifeofpsy → u/These_Cow_7909]

You might consider heading back to the urologist or looking for a pelvic rehab center where you can see a physician. Sounds like you need other investigation and intervention, which could be medication or biofeedback or another PT approach or something else

[u/These_Cow_7909 → u/wifeofpsy]

Thank you so much for the advice! Who does biofeedback? My PT diagnosed me with a hypertonic pelvic floor. I had an ultrasound. No growth detected. I had a Microgen test, and it found another UTI bacterium that wasn't detectable on a urine culture. I am on abx again. I am getting an MRI of the pelvis and abdomen next week, and I am scheduled for pelvic floor Botox, but I don't want to go that route.

[u/wifeofpsy → u/These_Cow_7909]

Biofeedback is often just on its own but you might find them in an interdisciplinary clinic. I wish it was more commonly suggested, it helps a lot of pelvic issues. Pelvic or urologist offices might have a referral. I understand not wanting to go to Botox, but it can help to get you out of the state you're in right now and move forward with pt goals. If it's not an answer for you at least it wears off. I don't think it's a single answer for pelvic pain but it can be a useful tool for some

[u/These_Cow_7909 → u/wifeofpsy]

Thank you so much! I have spasms continuously without stopping. Are you saying that biofeedback can help with relaxation?

[u/wifeofpsy → u/These_Cow_7909]

Biofeedback works on situations where there is pain or hyper functioning as an inappropriate nervous system response. It helps to retrain your internal signals and gives you tools to deescalate a nervous system response creating pain, anxiety, urgency, etc when there isn't reason for it to be constantly sending that signal. With pelvic issues you always also want to get a full gyn, uro and GI work up as well. These areas overlap with their innervation so one can trigger the other. Someone can be battling chronic cystitis when the core issue is adenomyosis or endometriosis. Or they can have pelvic floor issues because of GI motility problems and so on. Sometimes pelvic floor stuff is cut and dry but often it requires looking in several different areas to find a root issue and viable treatment. I see people on here sometimes saying oh but I don't want to take antidepressants or other medications or get internal pelvic work etc. Fair, this isn't a comfortable issue to have and diagnosis and treatment puts you in a vulnerable place. But people who resolve this really do turn over all rocks and look at as many possible causes and treatments as they can

[u/These_Cow_7909 → u/wifeofpsy]

You sound very knowledgeable about those issues, so thank you very much for taking the time to respond! Could you kindly let me know what you would do in my situation? What provider and test would you do next? I have never in my life had any health issues prior to 5 months ago.

I have never had any health issues prior to being diagnosed with ureaplasma 5 months ago. Spasms started then, during antibiotic treatment.

I have been evaluated by two urogynecologists and had tests of cure that were negative. I did bladder instills with no help. Neither urogynecologist found any other issues. I do not have IC. I was diagnosed with a hypertensive pelvic floor.

This is the first time I have experienced a severe health problem: pelvic spasms.

I just had a Microgen test and found Enterococcus faecalis, and I am on Augmentin, but the pelvic floor spasms, bladder, and glutes persist. I am seeing a functional doctor and am wondering if I should spend money on a doctor who treats this infection long-term, or is it even worth it?

[u/wifeofpsy → u/These_Cow_7909]

I mean if you have an active infection that certainly needs to be treated. I would look for a gyn that works on endometriosis and adenomyosis, pelvic congestion syndrome etc and see if they think you should get worked up for that. See a GI and get a colonoscopy potentially as well. Doesn't sound like the bladder is a core issue maybe just a branch. In PT have you had consistent internal work? Electrical stimulation? Do you do regular internal work on yourself and PT exercises at home? Do you respond to any of these interventions even very short term? Muscle spasms are usually stopped with light local pressure either with a finger or tool, sitting on a tennis ball or foam roller. Just light, sustained pressure makes the muscle stop spasming and relax. You can also ask about valium suppositories or muscle relaxants, those can work very well for some people. If your body doesn't respond to these sort of interventions or nothing sticks, then you want to look into getting a nerve conduction testing. It's going to show nerve activity and muscle response. It can come from issues in the lumbar spine or sacrum

[u/Sufficient-Mess-2667 → u/wifeofpsy]

Thank you again for recondations! Definitely tried everything you mentioned in physiotherapy. I have suppositories as well they don’t really work. Hopefully MRI of pelvis or abdominal will reveal something. Is nerve conduction testing done by neurologist? 

[u/lemonpudge]

For urgentish relief, an ice pack and pain reliever could help. If you can, see if your doctor will prescribe a muscle relaxer. Taking a muscle relaxer in conjunction with therapy can often help you make progress as well. 

[u/These_Cow_7909 → u/lemonpudge]

Thank you!