A question about Prolotherapy for tail bone pain
I have been in chronic burning pain in the tailbone/rectal area ever since I overstrained my low back and then had a complete hysterectomy. This has been about 2 years. After the hysterectomy a MRI has shown a prolapsed internal muscle wall possibly pushing against the levator ani. Anyway, there is a horrible burning/tingling pain in the whole sit down area that makes me feel like I’m going to pop.
I have had two prolotherapy treatments where the results did not last more than a couple days and I really don’t know if they helped at all.
Prolotherapy for the pelvic region
Answer: Most of the time this condition is caused by the perineal muscles contracting against an unstable base. We typically contract the muscles around the anus when we have a bowel movement, obviously, but also when we sneeze, cough or contract our abdominal muscles (like when we lift up from the laying down position. Remember muscles have power when they contract against a stable base. The perineal muscles specifically attach to the pelvic bones including the ischial tuberosity, coccyx and pubis. If the pubic, sacrococcygeal, sacrotuberous, sacroiliac, or iliolumbar ligaments are lax, stretched or injured, the perineal muscles can go into spasm. This causes burning rectal pain especially upon the valsalva maneuver (sneezing, coughing) or when having a bowel movement.
Prolotherapy and Neural Therapy
If this seems to describe you then you need to have the above areas evaluated and treated by Prolotherapy. When in doubt at Caring Medical we treat all the areas. If the pain seems to be tied to an operation such as the hysterectomy you had then we would do Neural Therapy (see also Prolotherapy and Neural therapy) into your hysterectomy scar and treat the autonomic nerves in the area. We do this by doing nerve blocks into the pelvic sympathetic ganglion. This has the effect of shutting them off for an hour or two and often when they turn back on they function more normally. In summary, burning rectal pain is common. People suffer from this condition for years because the underlying cause of the condition is not addressed. Potential causes include injury to the pubic, sacrococcygeal, sacrotuberous, sacroiliac or iliolumbar ligaments. When these ligaments are strengthened by Prolotherapy, the perineal muscle spasms cease. Sometimes the condition is perpetuated by autonomic nerves firing. To treat these neural therapy to a surgical scar or nerve blocks are given into the pelvic sympathetic ganglion. Over the course of the last 13 years, Caring Medical in Oak Park have treated many patients with burning rectal pain by this approach. In our experience this approach has been extremely successful.
Answer by Ross Hauser, M.D.