PUBLISHED RESEARCH

PUBLICATIONS OF AND ARTICLES ABOUT THE WISE-ANDERSON PROTOCOL AND OTHER RELATED ARTICLES

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Coccygodynia and Pain in the Superior Gluteal Region – October 1937, Jour. A.M.A., Volume 109, Number 16, George H. Thiele, MD, Kansas City, MO.

Coccygodynia was found to be accompanied by spasm of the levator ani and/or coccygeus muscles in sixty-four of sixty-nine patients seen by nine different observers. Spasms of the piriformis muscle was found in thirty-one of thirty-three patients with a pain in the supragluteal region or down the back of the thigh (Thiele’s and Wilson’s) There’s a sound anatomic basis for the causation of coccygodynia by spasm of the levator ani and coccygeus muscles and for the production of supragluteal pain and pain down the back of the thigh by spasm of the piriformis muscle. In the treatment of these complaints by massage of the pelvic muscles involved, the technic outlined should be carefully followed.

In a series of eighty patients with coccygodynia or pain in the supragluteal region or down the bac of the thigh who were treated by massage by eight different proctologists, 60 per cent were cured, 33.7 per cent were definitely improved and 6.3 per cent were unimproved.

Chronic Pelvic Pain Syndrome: Reduction of Medication Use After Pelvic Floor Physical Therapy with an Internal Myofascial Trigger Point Wand – R. U. Anderson Stanford University School of Medicine, Stanford, CA 94305, USA e-mail: rua@stanford.edu: R. H. Harvey Department of Health Education, San Francisco State University, San Francisco, CA, USA D. Wise _ T. Sawyer National Center for Pelvic Pain Research, Sebastopol, CA, USA; J. Nevin Smith Sonoma, CA, USA; B. H. Nathanson OptiStatim, LLC, Longmeadow, MA, USA.

This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1–10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes inmedication use were at the patient’s discretion. Changes in medication use were assessed by McNemar’s test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).

Success of 6 Day Intensive Program Wise-Anderson Protocol – Journal of Urology, 2011, Volume 185, Issue 4, p. 1294.

Patients with CP/CPPS with long-standing pain that is refractory to traditional treatment may benefit from focused myofascial TrP therapy and concomitant PRT. Education of patients in techniques for self-administered TrP massage and encouragement of continued pelvic muscle relaxation are assets in helping them to participate in the management of this chronic disorder. Refinement of clinical phenotyping and selection of patients with pelvic muscle tenderness should enhance the success rate with this treatment modality.

Award for Internal Trigger Point Wand – American Urological Association, 2011.

AUA chooses internal trigger point wand used and developed in the Wise-Anderson Protocol (Stanford Protocol) as an elite abstract presentation. Internal trigger point wand study abstract presented at the AUA chosen as 1 of 40 out of 2000 abstracts submitted for presentation at an AUA sponsored press conference.

The Scapegoat of the Prostate Gland and the Wise-Anderson Protocol – Bartlett’s Integrated Health Journal, 2011, Emilia Ripoll.

In the sixth edition of A Headache in the Pelvis: A New Understanding and Treatment for Chronic Pelvic Pain Syndromes, Drs. Rodney Anderson and David Wise state, “in 95% of prostatitis cases, the prostate is not the problem. In the case of men with prostatitis and chronic pelvic pain syndromes, 95% of patients who are diagnosed with prostatitis do not have an infection or inflammation that can account for their symptoms. In a word, in the overwhelming number of cases of men diagnosed with prostatitis, the prostate is not the issue.”

Report on the Success of Internal Trigger Point Wand and the Wise-Anderson Protocol – Medscape Medical News, 2011, Trigger Point Wand Eases Chronic Pelvic Pain, Jill Stein.

Report on success of trigger point wand used in the Wise-Anderson Protocol (Stanford Protocol). 87% completing 6 months of use report significant reduction in pelvic floor sensitivity/pain from 7.5 to 4 on a 0-10 scale. Patients used the wand two to three times per week for 5-10 minutes and were followed up at 1 and 6 months. Ninety-five percent (106/111) reported the therapy was very or moderately effective in relieving pain. Their average assessments of pelvic floor pain on a scale of 1 to 10 dropped from 7.5 at baseline to 4 at 6 months; 39% of patients reported a greater than 50% reduction in pelvic muscle sensitivity.

Report on Success of Internal Trigger Point Wand and the Wise-Anderson Protocol – Urology Times, 2011, Self-massage shows benefit in CP/CPPS patients with myofascial pain, Urology Times Daily Meeting Report.

Patients used the wand two to three times per week for 5 to 10 minutes and were followed up at 1 and 6 months. Ninety-five percent (106/111) reported the therapy was very or moderately effective in relieving pain. Their average assessments of pelvic floor pain on a scale of 1 to 10 dropped from 7.5 at baseline to 4 at 6 months; 39% of patients reported a greater than 50% reduction in pelvic muscle sensitivity.

Internal Trigger Point Wand in the Wise-Anderson Protocol – American Urological Association Poster, 2011, Abstract Presentation of Study of safety and efficacy of Internal Trigger Point Wand developed and used in the Wise-Anderson Protocol.

The personal therapeutic wand helped to achieve pain reduction or abatement in most patients thus ranking it very high amongst other multi-modal treatments. Patients required simple education regarding hygiene and adequate training in the careful application of the wand to prevent trauma to the anal or vaginal tissue. Self-treatment with an internal pelvic therapeutic wand appears to be a safe, viable treatment option in select refractory patients with pelvic pain.

Results of Internal Trigger Point Wand used in the Wise-Anderson Protocol – Clinical Journal of Pain, 2011, US National Library of Medicine National Institutes of Health, Clin J Pain. 2011 Nov;27(9):764-8.

Safety and effectiveness of an internal pelvic myofascial trigger point wand for urologic chronic pelvic pain syndrome., Anderson R, Wise D, Sawyer T, Nathanson BH. Source, Department of Urology, Stanford University, School of Medicine, Stanford, CA.

A multimodal protocol using an internal pelvic therapeutic wand seems to be a safe, viable treatment option in select refractory patients with pelvic pain.

The Failure of Conventional Drugs to Treat Prostatitis – Nature Reviews, Urology, 2011, Drug Therapies for CP/CPPS: help or hype, Anderson, R.U. & Nathanson, B.H., Nat.Rev.Urology 8, 236-237 (2011), Department of Urology, Stanford University School of Medicine, CA 94305-5118, OptiStatim LCC, P.O. Box 60844, Long Meadow, Mass 01116.

While the ineffectiveness of these drugs is old news to those of us who specialize in treating CP/CPPS, they are still routinely prescribed by most clinicians treating this condition—and patients continue to suffer from CP/CPPS. Underlining the failure of these conventional oral medications should have been the main conclusion of this article. The authors admit that “the reason for the benefit associated with antibiotics is not immediately clear.” Other non pharmacological therapies for CP/CPPS do exist, however, and the logical trend in the diagnostic evaluation of CP/CPPS is to utilize careful phenotyping in the initial work-up of the suffering patient. This phenotyping approach has recently been proposed and evaluated in a multimodal therapy setting, with excellent results.6 The differences in the management strategies used depend upon recognizing the heterogeneity of the condition and the specificity of symptoms, which are characterized by the six domains of the UPOINT phenotyping system (urinary, psychosocial, organ-specific, infection, neurologic/systemic, and tenderness of skeletal muscles) that are used for focusing treatment. Each of these domains should be treated with stateof-the-art therapy, which might sometimes require more than one treatment modality. Notably, pelvic tension and muscle tenderness make up the majority of the specific symptoms and physical findings in patients with CP/CPPS. In our personal experience of treating this condition, we have found alternatives to failed oral medications, such as multimodal physical therapy and cognitive behavioral therapy, and suggest that innovative treatment strategies be explored after patients have been carefully phenotyped and once traditional antibiotic or α-blocker therapy of CP/CPPS has been deemed inappropriate.

Report on Improvement in Symptoms of Men with Chronic Prostatitis / Pelvic Pain – Medscape Medical News, 2010, Intensive Therapy Regimen Helps Men with Chronic Pelvic Pain Syndrome, Jill Stein.

Report on Wise-Anderson Protocol showing sustained improvement in men with prostatitis/pelvic pain in 2010 study in the Journal of Urology

Report on the Success of the Wise-Anderson Protocol in the Journal of Urology – Doctor’s Channel, 2010, Journal of Urology, New Article Reports Wise-Anderson Protocol Helps 82% of Men Diagnosed With Prostatitis.

You can find the source video here on their website: http://www.thedoctorschannel.com/video/4146.html
Source: National Institute of Health and US National Library of Medicine at http://www.ncbi.nlm.nih.gov/pubmed/21334027

Men with chronic pelvic pain refractory to traditional treatment benefit from intensive myofascial trigger point therapy and concomitant paradoxical relaxation training. Education in techniques for self-administered trigger point release and continued pelvic muscle relaxation help patients reduce pain and dysfunction. Refinement of clinical phenotyping and selection of patients with pelvic muscle tenderness should enhance the success rate with this treatment modality.

Reports on Trigger Points and Prostatitis / CPPS – Journal of Urology, 2009, Oct 16 (Epub ahead of print) Painful Myofascial Trigger Points and Pain Sites in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome, Anderson RU, Sawyer T, Wise, D Morey A. Nathanson BH.

This report shows relationships between myofascial trigger points and reported painful sites in men with chronic prostatitis/chronic pelvic pain syndrome. Identifying the site of clusters of trigger points inside and outside the pelvic floor may assist in understanding the role of muscles in this disorder and provide focused therapeutic approaches.

Psychometric Profiles of Men with Chronic Prostatitis – Journal of Urology, 2008, Psychometric Profiles and Hypothalamic-Pituitary-Adrenal Axis Function in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome), Rodney U Anderson, Elaine K. Orenberg, Christine A. Chan, Angie Morey and Veronica Flores, From the Department of Urology, Stanford University School of Medicine, Stanford, California.

Men with chronic pelvic pain syndrome scored exceedingly high on all psychosocial variables and showed evidence of dysfunctional hypothalamic-pituitary-adrenal axis function reflected in augmented awakening cortisol responses. Observations suggest variables in biopsychosocial interaction that suggest opportunities for neurophysiological study of relationships of stress and chronic pelvic pain syndrome.

Cortisol and Men with Chronic Prostatitis – American Urological Association Poster, 2007, Variations in Psychometric Profiles and Awakening Cortisol Responses in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome, Rodney U. Anderson, MD, Christine A. Chan, MD, Elaine K. Orenberg, PhD, Veronica Flores, Angie Morey, MS Department of Urology, Stanford University, Stanford, CA.

CPPS men scored exceedingly high on all psychosocial variables and showed evidence of dysfunctional HPA axis function reflected in augmented awakening cortisol responses compared with healthy, age-matched controls. Whether these observations represent preexisting characteristics of individuals before the onset of CPPS which are activated by chronic pain, or as a consequence of stress associated with this condition, remain in question.Supported by grant from NIDDK, U01 DK065297

Improvement in Sexual Functioning after the Wise-Anderson Protocol – Journal of Urology, 2006, Sexual Dysfunction In Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Improvement After Trigger Point Release And Paradoxical Relaxation Training Rodney U. Anderson, David Wise, Timothy Sawyer, And Christine Chan, From the Department of Urology (RUA, CC), Stanford University School of Medicine, Stanford, Sebastopol, (DW) and Los Gatos (TS), The Journal Of Urology, October, 2006, p. 1534-1538. ABSTRACT, 1: J Urol. 2006 Oct;176(4 Pt 1):1534-8, Sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome: Improvement after trigger point release and paradoxical relaxation training Anderson RU, Wise D, Sawyer T, Chan C., Department of Urology, Stanford University School of Medicine, Stanford, California, USA.

The therapeutic methods in this report provide a 2-pronged approach to treatment, including the physical approach, focusing on the release of internal and external pelvic trigger points, and the psychological approach, involving relaxation training to help the patient gain control of tension. While to our knowledge the relationship between pelvic pain and disturbances in sexual function remains to be elucidated, these methods enhance symptomatic improvement in patients with refractory CPPS and associated sexual dysfunction. Future clinical trials with shamtreated controls are warranted to examine this new therapeutic approach in men with CPPS.

First Publication of the Success of the Wise-Anderson Protocol – Journal of Urology, 2005, Integration Of Myofascial Trigger Point Release And Paradoxical Relaxation Training Treatment Of Chronic Pelvic Pain In Men, Rodney U. Anderson, David Wise, Timothy Sawyer, And Christine Chan, From the Department of Urology (RUA, CC), Stanford University School of Medicine, Stanford, Sebastopol, (DW) and Los Gatos (TS), The Journal Of Urology, July, 2005, p. 155-160, ABSTRACT, 1: J Urol. 2005 Jul;174(1):155-60, Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men. Anderson RU, Wise D, Sawyer T, Chan C., Department of Urology, Stanford University School of Medicine, Stanford, California, USA.

This case study analysis indicates that MFRT combined with PRT represents an effective therapeutic approach for the management of CP/CPPS, providing pain and urinary symptom relief superior to that of traditional therapy.