Health Organization for Pudendal Education

I noticed this article about a randomized study for myofascial PT for IC presented at a conference in Chicago just this month. For the symptom of pain myofascial PT was found not to be significantly more effective that a regular full body massage.

The control group of patients were given a regular full body massage (not specific to the pelvis) and one group received myofascial pelvic floor PT. Blinding was not successful in the study so patients were aware they were in the control group (massage) and not having the correct treatment.

http://www.internalmedicinenews.com/new ... 7c641.html

At first glance it appears positive as the title for the article is

Myofascial Physical Therapy Appears Beneficial in Patients With Interstitial Cystitis.

As the second paragraph states

Among 81 women with interstitial cystitis and moderate to severe pain or urgency, global response assessment (GRA) rates at 12 weeks were 59% with myofascial physical therapy versus 26% with global massage therapy consisting of full-body Western massage.

So 59% people felt moderately or markedly improved after PT ( I always find it interesting these 2 categories are lumped together.) To asses this patients were asked this question.

As compared to when you started the study, how would you rate your overall symptoms now?”
1. markedly worse
2. moderately worse
3. slightly worse
4. the same
5. slightly improved
6. moderately improved
7. markedly improved

Participants who indicated they were 6: “moderately” or 7: “markedly” improved were considered intervention responders. This question is referred to in the study as the global response assessment.

So far so good.

However then we have this paragraph.

The secondary end points did not confirm the primary results, Ms. Kotarinos said. The MPT arm had greater mean changes in symptom scores than did the GMT arm on the Interstitial Cystitis Symptom Index (-3.2 vs. -2.2), Interstitial Cystitis Problem Index (-3.6 vs. -2.4), Likert Pain scale (-2.2 vs. -1.5), and Likert Urge Scale (-2.1 vs. -1.4), but the differences did not reach statistical significance.

The language is couched in scientific terms as to make it I suspect as unintelligible as possible.

What it means is that for symptoms of pain , urgency and frequency myofascial/trigger point treatment was found not to have a significantly greater affect than a regular full body massage.

Yes the patients reported PT to have a greater effect than massage generally but when the researchers asked patients to be specific on matters such as pain levels ( marked from 1 to 10) , frequency and urgency no significant difference between massage and PT was found. Massage and PT showed pretty much the same improvement when it came to this. Bear in mind the massage treatment was not even confined to the pelvis, it was full body massage.

I fully expect this nugget of information to drop like a stone in the pelvic pain world as it is not exactly good news for myofascial physical therapy.

I guess I always thought of deep tissue massage and myofascial PT to be pretty much the same thing, except my insurance pays for 60 PT visits per year and a massage comes straight out of my wallet.

HerMajesty wrote:I guess I always thought of deep tissue massage and myofascial PT to be pretty much the same thing, except my insurance pays for 60 PT visits per year and a massage comes straight out of my wallet.

Well if myofascial PT is cheaper than massage it makes sense to continue with PT. As the study above showed in terms of effectiveness for reducing pain they are about the same.

Interesting. I guess this explains why I feel a reduction in pain after a deep tissue full body massage! Wish my insurance covered it!

I want a full body massage!!! I pay $25 for each pt visit, so why not save my bucks and get a massage? I would be so worried about them injuring something, though. Then again, pt injured me before, too.

Do trained and licensed massage therapists learn about nerves, fascia, etc?

There are some extremely well educated and innovative massage therapists in the field. There are also some morons who slid through massage school just to get a job. So be careful, read their websites, look for recommendations. I have met some massage therapists through my work contacts, that have enough knowledge of nerves, fascia, etc to put most Doctors and PT's to shame.

I've gone every week for about 3 years for a massage. It took us a couple of sessions to figure out what he could and could not do. It has been a work in progress but he is willing to listen and work with me. I do notice a difference and now after 3 years there are areas on me that he can work on that he couldn't before so I am happy with the slow but steady progress. He still can't work on my inner thighs so he just ices them. I did a lot of research before I went to him. He is a licensed massage therapist after going to school and has taken a lot of advanced training in sports and trigger point massage. He works on individuals with alot of medical conditions and is not only very knowledgeable about RSD but works with patients with RSD. He owns a small massage business with a couple of other massage therapist and when he is on vacation he only lets one other massage therapist treat me because this other therapist is also very knowledgeable about the problems of working with anyone with medical conditions. If you decide to try this make sure you do your homework and find someone who really knows what they are doing. You just can't go to anyone.

I'll have to read the study but one thing a full body massage will do that pelvic floor PT doesn't address is the other areas of the body that get tight because of pain and holding yourself in different positions such as side sitting.

thanks for sharing the study.