Dr Michael Durtnall

[Alan1646]

There are some published studies showing that physical therapy/physiotherapy/massage is useful for PN. There is a lengthy discussion on these boards about the evidence produced by Dr Wise for example. There are some studies published about the type of injection given by doctors such as Dr Baranowski. But I have never heard of any studies showing the effectiveness of any chiropractor. That is one of the points I am questioning.

Often and perhaps usually, patients with PN symptoms find this site earlier on in their symptom history, ask about help with diagnosis and doctors. They often go from one specialist to another before being eventually diagnosed. There are no easy shortcuts as a number of other conditions have to be eliminated. The pudendal nerve block is considered to be an important diagnostic test for example, and many people have an MRI of the pelvis to eliminate the possibility of other diseases causing the pain.

Often, patients post on here for years and a few for a decade or more. Now, quite a number have posted about Dr Durtnall , one after the other. They have nearly all posted only once and only after they have been cured or substantially improved. They usually never post again. When they are asked questions, most never respond. How do you feel about this?

Aelwn's story has him/her going from their GP , who was "at a loss" (despite clearly knowing much more than the average GP about PN " My GP was familiar with work done in France on the pudendal nerve" to a doctor in Bristol who gave injections and then advised surgery. I find this rather disconcerting, as it's not clear how Aelwen got from her GP to the specialist in Bristol, particularly as the GP was at a loss. Did he/she see any other doctors? Were any other tests carried out?
Perhaps a great deal has been missed out, but this sounds very strange as it stands.

[Violet M]

There are some published studies showing that physical therapy/physiotherapy/massage is useful for PN. There is a lengthy discussion on these boards about the evidence produced by Dr Wise for example. There are some studies published about the type of injection given by doctors such as Dr Baranowski. But I have never heard of any studies showing the effectiveness of any chiropractor. That is one of the points I am questioning.

They usually never post again. When they are asked questions, most never respond. How do you feel about this?

Aelwn's story has him/her going from their GP , who was "at a loss" (despite clearly knowing much more than the average GP about PN " My GP was familiar with work done in France on the pudendal nerve" to a doctor in Bristol who gave injections and then advised surgery. I find this rather disconcerting, as it's not clear how Aelwen got from her GP to the specialist in Bristol, particularly as the GP was at a loss. Did he/she see any other doctors? Were any other tests carried out?
Perhaps a great deal has been missed out, but this sounds very strange as it stands.

There is some overlap in treatments used by chiro's, PTs, and manual therapists. Some PN patients have musculoskeletal anomalies such as SIJD or pelvic misalignment that are contributing to their pain and these may be treated similarly by PT's or chiros. I went to a chiro and a PT for my SIJD. So, I don't know all of the modalities Dr. Durtnall uses but I just pointed out in my previous post that he studied with some PT's so I would assume he uses the modalities that he learned from the PT's, not just what he learned in his chiro training.

I can't answer your questions about all of Aelwan's medical history and treatments. I agree with you that it would be nice if patients would stick around and continue to post their progress and take questions from other patients but we have no control over whether patients return to post again. They have not violated the terms of use of this forum so there is no action to be taken by the moderators.

Violet

[Alan1646]

What evidence is there that Dr Durtnall's treatments are effective for PN or PNE? You say he is Pudendal Hope adviser, so could you ask him to advise you then?
Is the only evidence the anecdotal accounts published on these forum boards or is there something else?
Has he explained to you, as a Pudendal Hope adviser, how he can tell exactly where a nerve is irritated and how he treats that condition?

[Violet M]

Alan, that's kind of like asking what evidence is there that any treatment for any illness is effective. For some conditions, especially pain conditions, you can only conclude the treatment is effective if people get well and tell you that they got well. It's all anecdotal when you come right down to it. This forum is a place for people to tell their stories -- not a place for scientific research. But even scientific medical research may depend on getting feedback from the patient.

Dr. Durtnall explains on his website how he treats pelvic pain. http://www.sayerclinics.com/conditions- ... ccyx-pain/
You can also read about his research. http://www.sayerclinics.com/conditions- ... ccyx-pain/
The reality is that pelvic pain patients don't have a lot of options and there isn't a ton of research for any therapy that gives you a 100% guarantee of success. If you can point us to something that does, Alan, that would be great. I haven't needed to get advise from Dr. Durtnall so far but based on my previous communications with him, I am sure that if I emailed him a question, he would be more than happy to answer it. There is an email address on his website and I suspect if a patient emailed him with questions that he or one of his staff would respond. My experience with him has been that he's a very nice guy.

People can make up their own minds whether they want to try the type of therapy Dr. Durtnall offers. If Dr. Durtnall can help even some people, it is worth it to have posted his name on this website. I am grateful for any providers who are willing to treat patients like us. It's not like treating pelvic pain is a glamorous occupation.

Violet

[Alan1646]

The paper is entitled : Manipulation for coccydynia

His research says this : "Eighty-seven consecutive patients who presented at a chiropractic clinic with coccyx pain". I'm not clear what this has to do with pudendal neuralgia.
A high proportion of these people had suffered an injury:"62% had a history of trauma to the area of the coccyx".
Please explain how this is relevant.

[Violet M]

Sorry, I noticed that there is the same link twice in that previous post. I meant to post another link but it seems to revert to that same page every time. So instead, go to the link http://www.sayerclinics.com/conditions- ... ccyx-pain/# and click on the "Conditions" tab and there is more info on how they treat pelvic pain at the Sayer Clinics. You may have to click the tab several times to get it to work. In that page under the "Conditions" tab, Dr. Durtnall points out that there is "limited large-scale research" on the physical treatment for pelvic pain. You are correct his research only includes 87 patients but it isn't just on coccyx pain -- some also had pelvic pain. So from that do we conclude that no one with PN should try any type of physical treatment (PT, or manual therapy, etc.) for chronic pelvic pain?

I am not prepared to tell people they should wait for some large-scale studies (that may never happen) on the effectiveness of PT and manual therapy for pelvic pain conditions before trying this option. Over the 12 years I've been moderating the PNE forums, we've had too many people post that they found these treatment modalities significantly helpful.

Violet

[Alan1646]

Violet, As you know very well, I asked for evidence that Dr Durtnall's methods are effective for Pudendal Neuralgia. Eventually, after many months you supplied a link to his own study that is about coccyx pain.

"Eighty-seven consecutive patients who presented at a chiropractic clinic with coccyx pain"

Yes, he does say that some of these patients had additional pelvic pain but it doesn't mention pudendal neuralgia at all and he doesn't say how many had additional pelvic pain. He doesn't say whether any of those with additional pelvic pain were helped by his treatment. It's quite possible that none of the patients in the study had been diagnosed with pudendal neuralgia, from the information given. If any patients in the study did have pudendal neuralgia, diagnosed by a qualified medical doctor, perhaps you could ask Dr Durtnall to advise you of their number and the long term outcomes, if any.

"Some of these patients had additional pain, such as pelvic pain" . "Pelvic pain" covers a very broad area and can be caused by a multitude of factors, including cancer and prostate problems. This website is specifically for patients with Pudendal Neuralgia and Pudendal Nerve Entrapment, so I fail to see any relevance of this study for us.

Other "evidence" included on his website, includes this statement:"
Read the 130 coccyx testimonials for Michael and his team at http://www.coccyx.org/treatmen/docsuk.htm and www.coccyx.org

and pelvic pain patient reviews for Michael Durtnall on the UK and Ireland forum of www.Pudendalhope.info"

So you can see that his website uses an imperative to urge people to read anonymous and unverified reviews on the HOPE website. Unlike the Amazon website, which has been criticised for reviews as you may know, there is no check that those who wrote the reviews bought the product.

To clarify this, I mean that Amazon states whether someone who has left a review has actually bought the product from Amazon. In HOPE's case , there is no such confirmation.

I won't go into a detailed analysis of the language used in his website, but would mention the number of imperatives used and the promotional tone.

[Isabellucy]

I haven't been on here since posting a success story a year ago, I've just read someone else's post saying that when you're not in pain anymore you want to put it behind you and move on and I think that is true in my case.
However I also read "wannagetbetter"s post and wanted to give some reassurance by adding to my story.
Here is my original post:

I had suffered with awful pelvic/ vulval pain since an episiotomy with my first child. After months of searching for help I was prescribed Amitryptyline for nerve pain which gave a lot of relief. When I found the courage to have another child I was again in terrible pain having torn badly. My pains were many and varied from burning, itching and aching to caught hair feeling. I couldn't sit and couldn't wear trousers or tight underwear. I managed to see a physiotherapist from Chicago called Rhonda Kotarinos. She concluded that the problems all stemmed from dense scar tissue around tear and episiotomy sites.
This had compressed the posterior femoral cutaneous nerve causing the pain. Years of tensing and the dense tissue had lead to very decreased blood supply to the whole area. The surrounding tissue including my buttocks and thighs had become very restricted and tight hence not being able to sit etc.
I was in a complete mess and at the end of my rope. She recommended intense physio in the form of sub cutaneous tissue massage and dry needling to the scar tissue. She was going back to Chicago though and I didn't know where to turn.
A friend recommended Dr Michael Durtnall a Chiropractor based in London. I went to see him and thank goodness I did!
He was amazingly knowledgable and very easy to talk to. Obviously these problems are embarrassing to discuss, especially with a man but he made me feel very at ease. He took X-Ray's in his office which was so convenient. He examined me and was able to find all the problems Rhonda had, which no one else had been able to do. He also found my coccyx to be misaligned and said this would contribute to the nerve and muscle problems. He was able to re-align it within two sessions and I could feel the difference. He massaged all the restricted tissue and I also went to Maria Elliot, a physio for further massage.My symptoms were improving greatly over a few weeks and I can't describe the relief!
What I feel did the most good is the dry needling which Michael was able to give expertly. He found the right point in my scars and I can't say it wasn't painful but within a few sessions the difference was amazing. Finally my scars felt normal and so did I!
I was able to sit and wear trousers and sex was no longer painful for the first time in 8 long years. I had to work hard myself, walking lots to increase blood flow and self massage. I know I wouldn't be better today though if not for Michael and I will be forever grateful to him for giving me my life back.
Don't give up hope if you are suffering. I started to believe I would never get better but it is possible with the right help.
I hope this is some help.
Beth.

I was originally diagnosed with pudendal neuralgia by Dr A Baronowski and had 2 expensive nerve blocks that didn't help at all. When I saw Rhonda she said that people are often diagnosed with it due to lack of knowledge surrounding muscle/ tissue and coccyx involvement in pelvic pain. I was eventually told by Baronowski and his team that I would probably just have to live with it though I could try morphine patches. They then asked me why I was crying!! In the year since my post I have had a flare up of pain which I initially panicked about. Rhonda reassured me by e mail. I went to see Michael again and he said that some tissue felt a bit restricted and that my scar was feeling a little dense. He said my coccyx had stayed in place quite well though, he did some massage and some dry needling into my scar. I also went to see Helen Keeble at the white hart clinic in Barnes. She was also at the training with Rhonda and has made pelvic pain her speciality. She is also very good especially at tissue manipulation and pelvic muscle assessment. Between the 2 treatments and lots more walking, self massage and distraction I totally got on top of the pain and have been fine since. I would strongly encourage anyone with pelvic pain of any sort to see Michael and Helen. Even if you've been told to live with it or that you need surgery. I realise there is a lot of scepticism on this forum but I'm happy to keep replying to posts or to message people privately,
Don't give up! I really nearly did but I genuinely feel like a miracle has happened to me.
Beth

[Violet M]

Good for you, Beth. Glad to hear you are so much better and thanks for posting.

Alan, I think you have completely missed the point. This is not just about Dr. Durtnall -- it's about all of the PT's. If you are going to complain about him and the methods he uses then essentially you are complaining about all of the PT's because they use similar methods. You don't have to try PT if you don't want to. No one who comes here has to try PT if they don't want to.

HOPE makes no claims about the accuracy of experiences people post on these forums. You don't have to read the posts if you don't want to. This is a place where people can come and meet each other and share stories. I think most people are smart enough to know this is a public forum. Over 12 years of moderating the forum I have gotten to know many wonderful people and there have been very few "bad apples" who post on a regular basis. Personally, I found the pudendal forums to be invaluable in my own recovery but I can understand if you don't feel the same way. Nevertheless, if we can help even a few people here, it is worth it.

Violet

[Violet M]

By the way, Alan, what would you recommend trying instead of PT?

Violet