A 25-Year Journey with Fibromyalgia, Rheumatoid Arthritis, Spinal Alignment, and Pelvic Floor Dysfunction
I've been facing significant challenges concerning my pelvic floor health. In 2022, I was diagnosed with a hypertonic pelvic floor. My main issues involved incessant urination, occurring approximately every 30 minutes. On two occasions, I found myself unable to urinate for extended periods, which was quite distressing. A KUB ultrasound and a urodynamic test were performed, both yielding normal results. Unfortunately, my condition remained largely unaddressed. While I did start physical therapy, my therapist concentrated on internal techniques that I couldn't manage, which led to my decision to discontinue sessions – although I recognize now that I should have persisted. The urologist who referred me for therapy couldn't even complete the internal examination due to the tension in the area. Three months ago, I began to experience significant nerve pain in my pelvic floor, predominantly on the left side, with discomfort occasionally radiating to the right. Simple activities like lying on my stomach, sitting for longer than 15 minutes, or standing—even briefly—have become unbearable. I endure incredibly painful episodes during which my pelvic floor becomes so tight that I can't urinate, pass gas, or have bowel movements, leading to severe pain that makes me feel faint. Relief only comes when I manage to urinate or have a bowel movement, which I often have to do while standing. Furthermore, I have discovered that sedatives or any medication that causes sedation disrupt my ability to urinate; this was particularly evident with muscle relaxants I had taken. When I mentioned this to my urologist, she was perplexed, asking why, and I could only shrug in confusion. Currently, I am prescribed Lyrica at 25 mg and Meloxicam at 15 mg. I suspect my symptoms might have intensified due to the repetitive strain from climbing numerous steps in my home daily, which has led to discomfort in my hip bones. Additionally, I experience muscle spasms in my back, and I've noticed that when my back pain escalates, so does the tension in my pelvic floor. Although I've been advised to return to physical therapy, I hesitate due to my lack of understanding about my condition and the fear that movement could exacerbate my pain. Before proceeding, I wish to gain a clearer understanding of the issues at hand. I have a few questions: - What might be happening in my situation? - Why do sedatives prevent me from being able to urinate? - Given my discomfort, what imaging tests would you recommend (noting that an ultrasound is not an option due to abdominal pain)? I would appreciate any additional insights or advice you may have. I’m in desperate need of help.
Answers (1)
2/14/2026, 7:10:41 PM
OpenHealth AI
I understand that you're navigating significant challenges with pelvic floor dysfunction, and I commend your effort to seek clarity about your health. Let's break down your concerns and questions while focusing on actionable steps to improve your situation.
Main Points:
- Possible Causes and Mechanisms: You may be experiencing heightened tension in your pelvic floor due to a combination of hypertonicity, nerve pain, and possibly contributing factors like spinal alignment.
- Impact of Sedatives: Some sedatives can relax muscles throughout the body, including those governing urination, which may lead to difficulties.
- Imaging Considerations: While an ultrasound is not feasible due to your abdominal pain, other imaging methods can be considered for further evaluation.
Explanation:
- Pelvic Floor Dysfunction: Hypertonic pelvic floor muscles can lead to issues such as urinary urgency and difficulty voiding. Your history of chronic pain conditions could exacerbate muscle tension and lead to nerve-related sensations.
- Sedatives and Urination: Medications like muscle relaxants can affect nerve signals and muscle contraction in the pelvic region, leading to urinary retention or difficulty. Such interactions can vary widely among individuals based on their unique physiology.
- Imaging Options: If an ultrasound isn't suitable, a Magnetic Resonance Imaging (MRI) might provide valuable insights into muscle and nerve structures or a CT scan if it can be performed comfortably. These can visualize soft tissue without affecting the pelvic floor significantly.
Next Steps:
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Consider Working with a Specialized Physical Therapist: Before resuming therapy, seek a pelvic floor specialist familiar with hypertonic pelvic floor dysfunction who can help you at a manageable pace. They can use techniques like relaxation exercises or biofeedback, focusing on your comfort level.
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Pain Management Strategies: Discuss potential adjustments with your prescribing clinician regarding Lyrica and Meloxicam. They can explore additional medications or therapies that may help manage your nerve pain and muscle tension without side effects impeding urination.
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Lifestyle Considerations: Identify ways to reduce physical strain, particularly with stair climbing. Gentle stretching and relaxation techniques, such as mindfulness or yoga, may help alleviate tension.
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Seek Further Evaluations: If unrelenting symptoms persist, consider asking for a referral to a pain management clinic or a multidisciplinary team that encompasses urology, physical therapy, and potentially a neurologist.
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Document Your Symptoms: Keep a diary of your symptoms, triggers, and any patterns you notice regarding your pelvic floor issues and physical activities. This record will be helpful for any future consultations with healthcare providers.
Your situation is complex, and I empathize with the distress you're experiencing. Taking small, manageable steps can lead to gradual improvements, and seeking specialized care can empower you to better manage your condition. Please continue to reach out for support, and let me know if you have further questions or if something specific needs more attention.
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