شرح مفصل عن العلاجات التى يتم تقديمها في عيادة الدكتور مايكل في لندن

 

‘Dr Michael Durtnall’s Sayer Pelvic Pain Clinics in London are the world-leading Coccyx pain, Pelvic Floor Pain, Vulvodynia, Vulvar vestibulitis and Pudendal Nerve pain specialist musculoskeletal treatment Clinics.

The world’s top coccyx and pelvic pain specialist Dr Michael Durtnall leads his skilled Pelvic Pain Physiotherapy Team of Sofia Ornellas Pinto, Marta Dias De Oliveira, Karolina Krzaczek and Katy Goncalves who are excellent pelvic therapy specialist physical therapists and the most, caring and experienced for successful treatment of pelvic pain, neck, chest and back pain manual specialists at our three clinics in West London: near Kensington High Street W8, in Central London W1 near Bond Street West End and in East London near Moorgate in the City of London EC2.

 

Dr Michael Durtnall is uniquely experienced and expert in spinal manipulation and acupuncture, in digital radiology (x-ray) and pelvic diagnostic ultrasound as well as pelvic joint manipulation, external and internal pelvic muscle, ligament, fascia and nerve pathway mobilisation and physical therapy.
Sayer Clinics are the world’s best spinal clinics, painlessly curing neck, back, rib, chest & costochondritis pain with postural rehabilitation for a pain-free life after treatment with Michael, Sofia, Marta, Karolina and Katy.

Read the 140 coccyx testimonials for Michael and his team at http://www.coccyx.org/treatmen/docsuk.htm and www.coccyx.org as well as 30 pelvic-pain patient reviews for Michael Durtnall and his team on the UK and Ireland forum of www.Pudendalhope.info.

 

Read here 10 years of Michael’s research on coccyx.org at ‘Chiropractic and Acupuncture works for acute & chronic Coccyx pain/dislocation and read his 2012 statistics on 87 consecutive coccyx and pelvic pain patients and http://www.coccyx.org/medabs/durtnall.pdf on http://www.coccyx.org/medabs/durtnall.htm

 

Many doctors have not heard of pelvic-floor physical therapy. Pudendal neuralgia, coccydynia and vulvodynia can be excruciatingly painful and chronic, yet surprisingly the majority of women who suffer neuro-musculoskeletal referred pelvic pain are still treated with surgery, nerve cauterisation, cortisone injections, addictive painkillers, anti-epileptic and antidepressant drugs.

First book your one hour ‘initial consultation’ to see
Dr Michael Durtnall for a thorough examination and a clear diagnosis and curative rehabilitation physical therapy instead of ‘cut-it out’ or ‘cover-up pain’ treatment.

What we do!

Our manual therapy works on connective tissue restrictions caused by dysfunction or injury in muscles, pelvic nerves and joints or which develop as a reflex from malfunctioning abdominal and pelvic organs. Connective tissue which has thickened over time, reduces local blood flow and entraps or sensitises nerve endings, causing pain.
We use skilled connective tissue manipulation to mobilise, improve blood circulation, desensitise and reactivate muscles and nerves affected by pelvic and coccyx syndromes in women and men. Pelvic floor pain with sitting typically causes widespread connective tissue thickening of pelvic floor muscles, pubis, perineum, the inner sitting bones (ischial tuberosities) buttocks and groins. We also examine for tissue restrictions and postural contractions of the chest, pectorals, intercostals, upper abdominal muscles and diaphragm.

We diagnose with the latest 2017 super-low-dose, extreme high-definition standing digital x-ray imaging to detect and accurately measure leg-length difference, scoliosis and sacroiliac joint twisting in patients suffering pubic symphysis dysfunction, coccyx and pelvic neuralgia pain.

 

Symptoms of musculoskeletal Coccyx and Pelvic Pain which we routinely and successfully treat at Sayer Clinics London:

Our patients typically suffer from 2 or more of these symptoms:
Coccyx – tailbone pain
Low back pain
Sacroiliac pain
Pain with sitting
Urinary Frequency and Urgency
Rectal pain
Perineum pain

Male Genital Pain – parasthesia / numbness – gluteals, buttocks, pelvis, perineum, testicles, penis, lower abdomen, inner thighs.

Female Genital Pain or parasthesia, numbness – buttock, anal pain, pelvic floor muscle tightness or tension or weakness, perineal burning nerve pain, vulval and labial inflammation, one or both sides internal vaginal muscle pain, contraction or weakness, clitoral hypersensitivity or persistent genital arousal dysfunction (PGAD) or insensitive, loss of clitoral sensation, clitoris pain with loss of orgasm, lower abdomen or pelvic floor pain and altered sensations – parasthesia.

Lower abdominal pain – parasthesia – tingling altered sensations in lower legs

Pelvic pain during or after sex

Pain or relief after bowel movement

Stress increases pain

Depression, anxiety or catastrophising about chronic pain

Medical tests find no pathology or disease

Drug treatments ineffective with miserable side effects

 

Book Online 24/7 at www.sayerclinics.com for Sayer Clinic Kensington W8, Moorgate EC2 in the City or Welbeck Street W1
Please call Alexandra or Lucie on 020 7937 8978 from 8am-8pm Monday to Friday and Saturdays 9am-2pm or email mail@sayerclinics.com to ask us any questions.

—————————————-

Sayer Clinics are world-leading Pudendal Neuralgia, Coccyx pain and Pelvic Pain Specialist Manual Clinics

First book at Sayer Clinic: Kensington W8 to see Dr Michael Durtnall for your initial consultation, x-rays and/or diagnostic ultrasound and to start effective treatment. Michael combines specific rehabilitation with his highly skilled specialist pelvic and coccyx pain Physical Therapists, Sofia Ornellas Pinto, Katy Goncalves, Karolina Krzaczek and Marta Dias de Oliveira at Sayer Clinics EC2, W1 or W8.

We successfully treat patients every day who travel to us from all over the globe.

We know that the sooner you start treatment to improve your flexibility, posture, mentality, positivity, exercise and fitness the sooner you will achieve and maintain great future health!

Pelvic pain is often the result of long-term, slumped sitting positions, compressing nerve pathways where they pass through the lower sacrum and coccyx, with burning nerve pain into the deep pelvis. This nerve damage instructs deep gluteal muscles to contract to protect the nerves with resulting self-perpetuating, deep muscle spasms near the sitting bones of the pelvis with referred pain felt in the genitals, perineum, abdomen and buttocks.

The first step, is tests to exclude any previous pathological, urological or gynaecological causes of your pelvic pain.

Diagnosis depends on a thorough history and physical examination of the complex interaction between all structures leading inevitably to complex dysfunction throughout the body. Leg-length differences of a centimetre or more, for example, can cause significant pelvic tilt and shearing forces at the sacro-iliac and hip joints which in time can cause degenerative changes in these joints. We address this with graduated heel-lifts to balance the leg-length and spine.

Specific joint manipulation, physical therapy ‘nerve tissue tension releases’, neural mobilisation and local medical acupuncture all help regain function. Misalignment of the pelvis, sacro-iliac joints, facet or sacro-coccygeal joints with associated muscular spasms are usually interrelated factors.

A variety of medical terms exist to describe Chronic Pelvic Pain Syndromes (CPPS): these include Pudendal Neuralgia; Pudendal Nerve Entrapment; Chronic Prostatitis; Interstitial Cystitis; Proctalgia fugax, Levator Ani syndrome, as well as Vulvodynia and Clitoral pain, hypo-sensitivity or hypersensitivity.

However, these pain syndromes are often over-confidently and simplistically labelled yet poorly understood with vague diagnostic tests and pain-masking treatment.

Sufferers consult urologists, neurologists, gynaecologists, dermatologists, proctologists, rheumatologists and orthopaedic surgeons to treat their symptoms which are in most cases secondary to inter-dependent neuro-musculoskeletal causes. As a result, symptoms almost always return in some form or are never completely eliminated.

A diagnosis of pudendal nerve entrapment (PNE) by a neurologist usually leads to nerve block injections and drugs to dull the brain’s perception of pain. This will temporarily mask symptoms yet allow the patient to keep compressing and damaging their nerves, while unaware of the pain.
Invasive surgery may cause fibrotic scar tissue in skin, muscle and fascia while cutting pelvic ligaments will permanently weaken pelvic stability.

There are multiple nerve entrapment sites within the pelvis which are not best addressed by surgery but by expert manual therapy.

Our unique clinical experience over the years has shown us that these pelvic pain conditions are very closely interrelated and associated with often simple factors such as: connective tissue, fascia and ligament laxity; prolonged sitting and physical inactivity (due to job/lifestyle); pelvic asymmetry; previous (forgotten) falls and other injuries from years before.

Biomechanical muscular imbalance from prolonged slumped, asymmetrical sitting, cycling, weight-training and repetitive strains to the pelvic floor, sacroiliac and coccygeal joints can cause muscular spasm, hypertonicity and painful thickened, fibrotic myofascial adhesions with the potential to trap the pudendal and perineal nerves within these deep pelvic muscles.

The Pudendal nerve is extremely specialised, controlling a complex web of urogenital sexual sensation and function, control of bladder and pelvic floor muscular function plus fascial connections to pelvic and abdominal viscera. The pudendal nerves as well as the urethra pass through pelvic fascial structures and may be compressed or irritated if pelvic fascia, internal pelvic muscles or ligaments to the bladder, prostate, urethra, rectum, anus, pubis, sacrum and coccyx are in pain and spasm.

Our experience over 35 years allows us also to use words, ideas and motivation – what some would now call “mindfulness” – to increase confidence and fitness by degrees, empowering our patients to become pain-free and regain control over their bodies and general well-being. We certainly do not believe in covering or blocking pain as a short-term goal for short-term pain relief.

 

There are only so many things that can cause pain; if it isn’t infection, if it isn’t a skin disorder and if it isn’t cancer then the chances are that it has a nerve – muscle – or skeletal basis so most pelvic pain can be physically solved and effectively treated.

Michael Durtnall DC MSc (UCL) FRCC (Orth)
Chairman Sayer Clinics: London
Fellow Royal Society of Medicine
www.sayerclinics.com

Sayer Clinics Summary of Intense Treatment
Generally, patient treatment may range from daily or 2-3 visits per week if fairly local to those who visit weekly, fortnightly or monthly.

Sayer Clinics’ intense protocol condenses therapy traditionally spread over the course of months into 1-3 weeks, to keep it practicable for those travelling from very distant locations and reducing the need for subsequent trips. The initial intense treatment protocol comprises one to three weeks of daily therapy for those travelling from afar with:

• Spinal and Pelvic Manipulative Therapy 5 days/week, depending on patient response and tolerance.
• Manual Physical Therapy and Pelvic Active Release Techniques 5 days/week, depending on patient response and tolerance.
• Lifestyle Modifications.
• Exercises and Dietary Interventions.
• Education of causes, aggravating factors, strategies for management and prevention.
• Biomechanical Correction of lower limb, spinal and pelvic biomechanical gait anomalies.
Each of the above therapies follow scientific evidence in the treatment of pelvic pain syndromes, however none have been combined in such an intensive, focussed way which we find to be extremely successful in patient pain scores and improvement of tissue and joint function outcomes.

Book online 24/7 here or email mail@sayerclinics.com or call Alexandra or Lucie on 0207 937 8978.

🌞We are always here to help you 🌞
Sayer Pelvic Pain Clinics’ unique neuromusculoskeletal approach to Pelvic pain.

 


Sayer Clinics
T: +44(0) 207 937 8978
M: mail@sayerclinics.com
Facebook: www.facebook.com/SayerClinics
Twitter: www.twitter.com/londonbackpain
www.sayerclinics.com