Dr Michael Durtnall

[Violet M]

You completely missed the point, Alan. He's not on the list because of his chiro training. So why are you asking for evidence that chiropractor treatments work?

Violet

[Alan1646]

You completely missed the point, Alan. He's not on the list because of his chiro training. So why are you asking for evidence that chiropractor treatments work?

Violet

Violet, No, I haven't missed the point.
The posts on these boards that state that Dr Durtnall treated them make it clear that he used Chiropractic adjustments on them. Therefore those adjustments are at least a part of what he does to treat their Pudendal Neuralgia.
For example you yourself say to "Lena":
"That's great that PT/chiro treatments helped you."
Another example of him using chiro adjustments is expressed by "Arsenal 123": ".Michael explained I would require adjustments with him"
He carried out adjustments on me so I know that he does them for PN.
I think it is important to know the risks of having chiro adjustments carried out on someone with PN and vital to know what evidence there is that it is beneficial.
I don't understand why you don't agree that evidence is important.

[cjmca]

Alan - yes he does chiro manipulations. He's not, in my opinion, primarily a treatment provider for PN. Does that mean he doesn't treat it? No. From a laypersons perspective, he's interested with any possible link between the skeletal system and PN. We know every PN case is different. I don't pretend to have huge amounts of knowledge on the subject of PN, but trapping a nerve can come from joints, and you can get referred pain elsewhere from a funky joint. Of course he's going to do chiro treatment on you if you require it, regardless of whether you have PN or not. As there are so many causes of PN, individuals like myself want to rule out the primary cause of PN being skeletal in nature. For me, thankfully, it's not the cause.

On top of the manipulation treatment, he is also able to evaluate the relationship between bone, muscles and nerves, which is why I went to see him. I have nothing wrong with my pelvic bone alignment, but I do with my pelvic musculature, and the main points he made about it were the same my physio in Dublin made. The muscle is compromising the pudendal nerve.

You're asking for specific evidence that chiro treatments fix PN. In my opinion, and it is just my opinion, given the nature of PN it requires a multidisciplinary approach. Some people may have a wonky hip which in turn tightens muscles of the pelvic floor which in turn irritates the nerve. Without adjusting the hip, I don't know how that scenario would pan out.

I have trawled the internet until I've practically driven myself crazy looking for specific evidence for all the treatments available for PN. There's empirical evidence that is pro nerve block and anti nerveblock, pro physio and anti physio, pro latency test and anti latency test, pro Lyrica/amitriptylene and anti. Jaysus you wouldn't know what to think of any of it.

I've come to my own conclusion - EVERYBODY is different. What'll work for one, won't work for another. It's exhausting trying to find out not just an effective treatment, but what caused it to begin with. I don't think I'll ever know what caused mine - I'm sure it was more than one thing. There is very little evidence that I can find, for example, on pulse radio frequency treatment for PN. But I'm having it done next week.

Even if I didn't believe in a treatment and it hadn't worked for me, I wouldn't knock it for everybody else. Even if a particular treatment worked for one person out of 100, to me that's a success and one less person out there who has to suffer this horrid affliction.

[Alan1646]

Of course he's going to do chiro treatment on you if you require it, regardless of whether you have PN or not.

I understand your post, but please understand I that am asking about evidence. You refer to amitriptyline as an example of a treatment for which there is evidence "for and against". But there is a wealth of evidence that it helps neuropathic pain, and that the number needed to treat is about 2.There are numerous published studies showing this. I know of no such evidence for Chiro and PN. If someone has nerve pain, we know that is plenty of scientific evidence that elavil will reduce the pain by about 50% or more in half the patients who take it. .Also, we know very clearly what the statistical risks/side effects are for Elavil. For Chiro and PN we don't know what the risks are and what the NNT is. The only "evidence" for Chiro and PN that I am aware of is anonymous testimonials on this website. Dr Durtnall, on his website, encourages people to look here on this website for testimonials.
I would add that Chiropractic treatment is not risk free and it is the extent of the risk that needs to be quantified. Here is a link to an article by Edzard Ernst , Emeritus Professor of Complementary Medicine at the University of Exeter. He states: "Several hundred cases have been documented in which patients were seriously and often permanently damaged after chiropractic manipulations. The latest to hit the headlines was that of a 32-year-old woman from Jakarta who died after being treated by an American chiropractor. What usually happens in these tragic instances is that, upon manipulation of the upper spine, an artery supplying the brain is over-stretched and simply breaks up, leading to a stroke which can prove fatal."
https://health.spectator.co.uk/the-evid ... than-good/
It is the lack of evidence which is a major concern:"About 30 deaths after chiropractic have been documented in medical literature, but they are probably just the tip of a much bigger iceberg. We have shown, for instance, that in the UK the under-reporting of such instances is very close to 100 per cent."

[cjmca]

Frankly, I don't believe half of the "evidence" posted on the internet. Besides that, measuring the effectiveness of a drug is far easier than measuring the effectiveness of a physical treatment. Personally, I think chiro can help with pudendal nerve problems, as I said before, if the hip or spine is out of alignment. No drugs are going to fix that. The only way I felt I could get a definitive answer as to the state of my skeleton was via a chiro. Then I happened upon a chiro that also took into account the state of my pelvic floor, which was an added bonus. Michael Durtnall is not just a chiropractor.

I think Violet has provided more than enough information for people to make up their own minds as to whether trying chiro is an option for them. For me, it was part of the diagnostic elimination process, and I'm glad I went. We all have to take risks in deciding whether to go for treatment or not.

I took amitriptylene and it made me horrendously depressed within the space of a week, I ended up suicidal and in hospital. Stopped the drug, and that feeling disappeared. Just because there is evidence of the efficacy of a drug and the dangers of chiro, doesn't mean there aren't dangers of a drug and benefits of chiro for someone else!

[Isabellucy]

Hi Alan,

I just wanted to check if you want me to post again about Dr Baranowski and how I was mis diagnosed with PNE?

I'm really sorry nothing has worked for you. To have something make it worse is devastating.

Best wishes
Beth

[Alan1646]

Frankly, I don't believe half of the "evidence" posted on the internet. Besides that, measuring the effectiveness of a drug is far easier than measuring the effectiveness of a physical treatment. Personally, I think chiro can help with pudendal nerve problems, as I said before, if the hip or spine is out of alignment. No drugs are going to fix that. The only way I felt I could get a definitive answer as to the state of my skeleton was via a chiro. Then I happened upon a chiro that also took into account the state of my pelvic floor, which was an added bonus. Michael Durtnall is not just a chiropractor.

I think Violet has provided more than enough information for people to make up their own minds as to whether trying chiro is an option for them. For me, it was part of the diagnostic elimination process, and I'm glad I went. We all have to take risks in deciding whether to go for treatment or not.

I took amitriptylene and it made me horrendously depressed within the space of a week, I ended up suicidal and in hospital. Stopped the drug, and that feeling disappeared. Just because there is evidence of the efficacy of a drug and the dangers of chiro, doesn't mean there aren't dangers of a drug and benefits of chiro for someone else!

I'm not clear whether you are saying that Dr Durtnall has cured you of Pudendal Neuralgia. Are you better now or are you continuing treatments with him in the hope of improvement? Many studies have shown that skeletal abnormalities are normal: very few people have perfect "alignment". Many, many people have bulging discs but no pain at all.https://www.painscience.com/articles/structuralism.php Or was your PN caused by surgery that went wrong somehow?
"The basic problem with structuralism is that biomechanical factors have surprisingly little to do with pain problems. The two things correlate poorly. But structuralism is deeply embedded in our cultural consciousness, and we cling to the idea that aligned and symmetrical must be the best way way to be, and we suffer in proportion to our deviations from that diagram. That equation makes intuitive sense to us, and we’re just not going to give it up easily!"

[Violet M]

I don't understand why you don't agree that evidence is important.

It is important but what do you do if you run out of things to try that are evidence based?

Alan, can I asked why you went to Dr. Durtnall if you didn't see any evidence for it?

Is there any evidence for restorative exercise in treating PN? May I ask why you tried that?

I guess we could all just give up trying.......????

Violet

[Violet M]

You know, if you want evidence based treatments from scientific journals then we could probably say here that surgery for PNE is probably as evidence-based as any other treatment in the literature for PNE. But there will be people who will vehemently disagree that surgery is something you should try -- based on what? The stories they have read on the internet. So which is it -- we should listen and take into account what other people say here or we shouldn't? We should believe the published literature or we shouldn't?

I completely agree with what cjmca said -- that what works for one person may not one work for another. That doesn't mean you should quit trying.

Violet

[Alan1646]

I don't understand why you don't agree that evidence is important.

It is important but what do you do if you run out of things to try that are evidence based?

Alan, can I asked why you went to Dr. Durtnall if you didn't see any evidence for it?

Is there any evidence for restorative exercise in treating PN? May I ask why you tried that?

I guess we could all just give up trying.......????

Violet

I tried so called "therapies" that weren't evidence based because at the time I hoped there was a slim chance that they might work.I was wrong. I did that because I'm human and humans make mistakes sometimes, especially when they're in pain.