There are a number of evidence-based treatment options for pelvic pain and pudendal neuralgia that are proven to work. And then there are the fake treatments peddled by scam artists pretending to be pelvic pain specialists. These “pretend” treatments are nothing more than smoke and mirrors that pretend to be new, innovative, cutting-edge, and minimally invasive when in reality they are just scams being pushed by snake oil salesman preying a patient’s desperation to trying anything in the hopes it will be effective. Some examples of these bogus treatments are:

• Hydrodissection: this is one of the worst scams out there. This is not a treatment. “Hydrodissection” is nothing more than the name given to what is seen when one injects a liquid under ultrasound and the tissue temporarily spreads apart due to the presence of the liquid: it gives the appearance of the tissue “dissecting apart” into different tissue planes. This is only visible for a few minutes until the body draws the liquid.  There is zero data on this “technique.”  Not only that, there is no coding for it with the American Medical Association (AMA) because they do not even consider this to be a real treatment thus it is not recognized.
  

This is not a treatment, it is a description. Fake pelvic pain specialists will try to sell this as a real treatment by saying how they will inject water to gently move adhesions and take pressure of pinched nerves in the pelvic region and decompress structures. THIS IS A SCAM. In a matter of minutes, the liquid is absorbed and the tissue goes right back to normal. Whatever was compressed or pinched will stay compressed or pinched as soon as the water gets absorbed.  Don’t fall for this one!

• Regenerative Medicine for Pelvic Pain: things like PRP, Alpha-2-Macroglobulin (A2M) and Stem Cell Therapy have a place in pain management, just not in pelvic pain. These treatments are used for sports injuries, joint pain, tendon/ligament treats – NOT PELVIC PAIN. They purposely create inflammation which can be extremely dangerous in patients with pelvic pain and potentially make symptoms worse  These treatments are meant to intentionally meant to create inflammation to heal certain types of sport injuries; using this in the pelvic region can be extremely painful and may even cause worsening of pain.
  

• Cryoablation (Cryo): This was a popular treatment in pain management over 10 years ago that went away for good reason – it doesn’t work. Cryo works by creating a large ice ball around a pain transmitting nerve, injuring that nerve which will then prevent it from sending pain signals to the brain. The major problem with cryo is, even if it works, the size of the ice ball can’t be controlled which can lead to other structures, like blood vessels and/or normal nerves, getting caught inside the ice ball and damaged unnecessarily. In the case of the pelvic region, everything is packed very close to together, meaning there is an extremely strong likelihood of catching something normal and unwanted inside the ice, freezing it and damaging it for no reason (i.e. ice shards inside the pudenal artery, ice burns to a motor nerve in the area thus causing incontinence or inability to have n erection, etc). Some doctors are trying to bring it back by making it seem new, different, and minimally invasive (especially for the pudendal nerve) so patients with pelvic pain will want to try it. Don’t fall for it – this went away on purpose.

• Cash Procedures: The procedures for pelvic pain that are proven to be safe and effective are largely covered by insurance.  Things that are deemed “experimental” or lacking evidence are typically not covered by insurance.  In many cases, insurance companies have selective hearing when it comes to certain treatments like DRG Stimulation that do have evidence and aren’t experimental but they play games so they don’t have to pay for the treatments.  For the most part, treatments for pelvic pain are covered by Medicare so if someone is offering a treatment for cash, find out if it is at least covered by Medicare – if not, ask more questions to find out why.  A good rule of thumb: if Medicare doesn’t cover it, then there is something wrong with the procedure.
  

If you come across a treatment that sounds different and you are interested in trying – do your research first.  See if there is evidence to support this treatment, have there been publications showing it is effective, is it approved for pelvic pain, and most of all – is it proven to be safe. Just because it sounds different or “makes sense” when it is described by someone doesn’t mean its effective or safe.  If you have any concerns or questions about a treatment, contact us via email and ask one of our doctors – we like helping patients and meeting new ones.