MECHANICALLY INDUCED PELVIC PAIN AND ORGANIC DYSFUNCTION
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CASE REPORTSCase No. 4PPOD symptoms: pelvic pain; genital pain, numbness and tingling; rectal pain; urinary frequency, urgency, dribbling and incontinence; pelvic pain with intercourse; loss of ability to achieve orgasm; loss of sexual desire; persistent vaginal discharge. A 29-year-old female presented with low back and left leg pain of approximately one-year duration resulting from a lifting injury. At that time pain and numbness had extended down the right leg into the foot and toes. Initial orthopedic evaluation resulted in a recommendation that she undergo spinal surgery. Desiring another opinion, she sought chiropractic treatment at another office. Spinal manipulation initially provided some relief of her back and leg pain, however her lower extremity complaints did not completely resolve. Gradually, over the next few months, low back and right leg pain increased in its intensity. Approximately one month prior to being seen by the author, she re-aggravated her condition while lifting provoking a return of her low back and right leg pain. In addition, intermittent left leg pain had begun to occur. Within hours of this re-aggravation, she experience to the onset of bilateral inguinal (ovary region) pain; constant sharp rectal pain (proctalgia); and urological disturbances consisting of frequency, urgency, post micturition (urination) dribbling and stress incontinence (urinary loss with coughing and straining). Upon detailed questioning, she admitted that during the month following her re-aggravation, she became aware of diminished genital sensitivity so that orgasm occurred a less frequently and was of a diminished intensity (anorgasmy). Accompanying her loss of genital sensitivity was an accompanying loss of libido. Further, dyspareunia (pelvic pain with intercourse) and leukorrhea (vaginal discharge) had also begun to occur. Shortly thereafter, sharp genital pain, along with numbness and tingling began to occur and would frequently radiate to the clitoris, making touch or contact of any type exquisitely painful. She stated that there was no accompanying bowel or menstrual dysfunction. One week prior to being seen by the author, a gynecologic examination, performed because of continuing pelvic complaints, failed to reveal any abnormal findings. As a result, she was advised to return only if her symptoms should increase. Clinical examination by the author revealed the presence of a Type I mechanically induced PPOD syndrome. Treatment following the Type I PPOD protocol resulted in progressive improvement of her complaints. Following one week of care, urinary frequency, urgency, dribbling and incontinence had completely resolved. Inguinodynia (inguinal pain), dyspareunia and proctalgia had significantly improved. Menstruation, which occurred during the course of care, was somewhat more painful than usual, although no abnormalities in flow or duration had occurred. After one month of care, all remaining PPOD complaints (pelvic pain, proctalgia, leukorrhea, depressed libido, genital pain and numbness, and anorgasmy) had resolved. |
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