Dr. Howard Liss treats disorders that cause pain and disability by providing consultative services and soft tissue and joint injections when needed. When medically appropriate, he makes specific referrals for diagnostic testing (lab work, imaging, electrodiagnosis), physical and occupational therapy, interventional procedures (epidurals and facet joint injections), and surgery.
With layers of muscles and soft tissues that extend from the tailbone at the low back to the pubic bone in the front, the muscles making up the female pelvic floor play a critical role in supporting the bladder, uterus and the bowel. Passing through the pelvic floor is the urethra, vagina and rectum, making these muscles significant in bladder and bowel control. Needless to say, when pelvic floor muscles weaken, they lose the ability to function normally, and women are at risk for developing a number of conditions including:
- Stress, urge and faecal incontinence
- Overactive bladder
- Antenatal care
- Postnatal care
- Vaginal prolapse
- Pelvic pain
While weakened pelvic floor muscles may certainly contribute to pelvic pain, there are numerous other factors at play such as problems with the organs near and around the pelvis (bowel, bladder, uterus and ovaries), as well as nearby muscles, nerves, blood vessels and joints. Even so, the following may also result in pelvic pain:
- Pregnancy-related problems (miscarriage, ectopic pregnancy, rupture, premature labor and placental abruption)
- Gynecological problems (menstrual pain, pelvic inflammatory disease, ovarian cyst rupture, fibroids, endometriosis, chronic pelvic pain and hormonal changes)
- Irritable bowel syndrome
- Low back injury
- Hip injury
- Varicose veins (pelvic congestion syndrome)
Treatment and Rehabilitation for Pelvic Pain
Without question, pelvic pain has varied causes, some of which are difficult to pinpoint. Yet, with expertise across multiple disciplines and knowledge relating to many interrelated conditions and structures, physiatrists are in a unique position to identify and discern treatment and rehabilitation for pelvic pain in women.
An important consideration in regard to pelvic pain is the condition of the hamstring muscles and possible irritation to the posterior femoral cutaneous nerve, which runs along the back of the thigh and leg. Yet, suppose an examination detects trigger points in the obturator internus muscle, which is a muscle in the pelvic floor. In both cases, patients may experience the same type of pain (localized pelvic pain), while the actual source of their pain is slightly different. In turn, while it may seem appropriate to stretch tight hamstring or hip muscles, doing so can activate pelvic pain by causing more irritation to trigger points in the pelvic floor. The bottom line regarding pelvic pain in women is that the source is often tied to trigger points or nerve dysfunction. It can only be detected through a comprehensive assessment and by ruling out other inflammatory conditions.
Once the root cause of a female’s pelvic pain has been determined, therapy may include pelvic floor drop (to decrease tone in the muscle tissues), squat drop, flat back drop, diaphragmatic breathing, hamstring stretching and lengthening (if trigger points are not detected) and other isometric exercises. As patients learn specific techniques, hormones such as adrenaline and cortisol are also released, which are elevated when the body is under stress from pain.
At the Howard Liss, M.D. Rehabilitation Institute, patients can rely on Dr. Liss to put together the right treatment, therapy and rehabilitation plan to ensure the most optimal outcome. Dr. Liss works closely with other specialists required to rehabilitate patients suffering from chronic pain or serious injuries, and Dr. Liss will refer patients as needed to ensure appropriate treatment. With extensive education and exposure to a variety of conditions that affect the cervical and lumbar spine, bones, nerves, joints, ligaments, tendons, muscles, brain, and spinal cord, Dr. Liss is uniquely positioned to help patients manage their pain and maximize their function.
If you or someone you love is suffering from pelvic pain, contact the Howard Liss, M.D. Rehabilitation Institute in Tenafly today.