Frequently Asked Questions

Pevic Pain FAQs

What causes Chronic Pelvic Pain Syndrome (CPPS)?

The exact cause of Chronic Pelvic Pain is not always clear. It can be caused by direct injury to the pelvis or coccyx, or caused secondarily due to disorders of the bladder, gynelogical system, or gastrointestinal complaints. Often patients with pelvic floor dysfunction may have no pain, but only have complaints of urinary frequency, or chronic constipation.

What is the best form of treatment? Is there a permanent cure?

The treatment of Chronic Pelvic Pain Syndrome often involves multiple providers working together to ensure a good outcome. We work in conjunction with the best specialists in the world including pelvic floor physical therapists, OB/GYN, Orthopedic surgeons, General surgeons and Urologists and Urogynecologists. Working to resolve the problem that began the Pelvic pain syndrome in addition to our treatments we perform in our clinic are very effective at treating pelvic pain and resolving the muscular dysfunction.

Can Chronic Pelvic Pain miraculously disappear?

It’s unlikely that Chronic Pelvic Pain will go away on its own. Even doing some treatments which are good, such as PT, acupuncture, yoga, or surgery may not be enough on their own to resolve the pelvic floor dysfunction. We strive to ensure that all of the aspects that are contributing to your chronic pain are addressed to get excellent results.

Is Chronic Pelvic Pain a form of anxiety?

Chronic Pelvic Pain is not a form of anxiety. However it can be worsened and perpetuated by chronic stress and anxiety. Additionally being in chronic pain can affect daily patterns and often patients may develop anxiety secondarily to having chronic pain.

Is Chronic Pelvic Pain only in my head?

Chronic Pelvic Pain is not in your head, and is not a form of anxiety. However it can be worsened and perpetuated by chronic stress and anxiety. Additionally, being in chronic pain can affect daily patterns and often patients may develop anxiety secondarily to having chronic pain.

I have had pain for a long time, is there a chance for recovery?

We treat patients regardless of the duration of pain. Patients who have been in pain for longer, may require a longer course of treatment.

Why do doctors ignore Pelvic Pain?

Many gynecologists are not typically trained in pelvic pain during medical school or residency. This is a major problem in terms of the training that they receive.  There are still many myths in both the medical and non-medical world regarding pelvic pain. This is something we hope to remedy by educating both the medical and non-medical community.

General FAQs

What is Pelvic Pain Rehabilitation Medicine?

Pelvic Rehabilitation medicine is a team of MDs who specialize in Physical Medicine and Rehabilitation. We strive to optimize function by reducing the chronic muscle tightness in the pelvis, allowing proper blood flow and nerve function to resume.

Why was Pelvic Rehabilitation Medicine started?

The Dr. Shrikhande, Dr. Hill and Dr. Ahmed used to all work independently at sports medicine practices- and wanted to combine forces to create a practice focused on pelvic rehabilitation only. We are hoping to raise awareness of the incapacity that can arise from pelvic floor dysfunction and to make it easier for patients to find the help that they need.

Does Pelvic Rehabilitation Medicine treat men too?

About 50% of our patients are men. Men often time have a harder time than women finding specialists who understand the causes behind their pelvic pain symptoms. Pelvic dysfunction is common in former athletes, cyclists, as well as in people with high stress jobs. Many will see multiple doctors and providers before finding a diagnosis for their condition.

I’m not located in New York. Can Pelvic Rehabilitation Medicine still help me?

We see patients from all over the world at Pelvic Rehabilitation Medicine. The work we do is not something that can be done via skype or telemedicine, but many patients chose to travel to NYC to see us in person.

What differentiates Pelvic Rehabilitation Medicine from other doctors or physical therapists?

At our clinic, we only treat pelvic conditions. We specialize in pain and dysfunction of pelvis primarily from a musculoskeletal perspective. We are also connected to the top specialists who treat pelvic pain conditions and are able to refer you to them if we suspect an underlying condition.

What types of problems do you see at Pelvic Rehabilitation Medicine?

Dyspareunia
Hip Pain
SacroiIiac Joint Pain
Buttock Pain
Vaginismus
Groin Pain
Vulvodynia
Pelvic Floor Hypertonia
Pudendal Neuralgia
Chronic Constipation
Urinary Urgency or Frequency
Persistent Genital Arousal Disorder (PGAD)
Endometriosis Pain
And any other pelvic pain or dysfunction

Do I really need professional help, or can I work this out on my own?

Typically pelvic pain that has gone on for more than 3 months, and does not resolve with rest and over the counter medications, will not improve on its own.

What happens at the first appointment?

The first appointment will take approximately 60 minutes. You will meet the doctor and share your history. You should also bring all imaging reports, and reports from any surgeries if you have had them. We will also examine you. Our examination includes analysis of body mechanics, low back, SI joint, and hips, as well as an internal examination of the pelvic floor musculature.

What treatment methods are used at Pelvic Rehabilitation Medicine?

The physicians at Pelvic Rehabilitation Medicine use a multi-modal approach in order to tackle the multiple facets of chronic pain. Treatment may include medications, topical creams, injections (trigger points and nerve hydrodissection), meditation and yoga, nutritional modifications, and referrals to various specialists in order to ensure all underlying medical conditions are treated.

Why a series of injections?

Trigger point injections work best in a series, as it can take multiple injections to reset the length tension curve of the muscle, and retrain it to remain in the lengthened state. There is a positive accumulative effect with each treatment.  Due to the large size of the pelvic floor, and the large number of branches off of the pudendal nerve, the best chance for pain relief is by doing a series of nerve blocks so that all of the branches off the nerve can be treated

How long does treatment usually take?

The treatment series is one visit a week for six weeks, with physical therapy occurring concurrently at one visit a week for six weeks. If your treatment requires medication management that typically lasts for six months, and is not typically needed long term.

What’s your success rate?

It’s high. For the most part 90% of the patients who see us have significant improvement in their pain and bowel and bladder symptoms. As pain is sometimes subjective we also measure quality of life surveys before and after treatment to measure how your function improves with the treatment as well.

You can read testimonials on our website for patients who have undergone treatment as well.

Is treatment covered by insurance?

Pelvic Rehabilitation Medicine accepts all major insurance carriers. You may contact the office to see what your coverage would be if you have any concerns.

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