WO2015081161A1 - Méthode et appareil pour le traitement de la douleur pelvienne - Google Patents

Méthode et appareil pour le traitement de la douleur pelvienne Download PDF

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Publication number
WO2015081161A1
WO2015081161A1 PCT/US2014/067551 US2014067551W WO2015081161A1 WO 2015081161 A1 WO2015081161 A1 WO 2015081161A1 US 2014067551 W US2014067551 W US 2014067551W WO 2015081161 A1 WO2015081161 A1 WO 2015081161A1
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WO
WIPO (PCT)
Prior art keywords
rod
patient
pressure applicator
wand
hand
Prior art date
Application number
PCT/US2014/067551
Other languages
English (en)
Inventor
David Wise
Original Assignee
David Wise
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US14/091,882 external-priority patent/US9622938B2/en
Application filed by David Wise filed Critical David Wise
Publication of WO2015081161A1 publication Critical patent/WO2015081161A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H21/00—Massage devices for cavities of the body, e.g. nose, ears and anus ; Vibration or percussion related aspects A61H23/00
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H19/00—Massage for the genitals; Devices for improving sexual intercourse
    • A61H19/40—Devices insertable in the genitals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
    • A61H23/02—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive
    • A61H23/0218—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive with alternating magnetic fields producing a translating or oscillating movement
    • A61H23/0236—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive with alternating magnetic fields producing a translating or oscillating movement using sonic waves, e.g. using loudspeakers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
    • A61H23/02—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive
    • A61H23/0254—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive with rotary motor
    • A61H23/0263—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive with rotary motor using rotating unbalanced masses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H15/00—Massage by means of rollers, balls, e.g. inflatable, chains, or roller chains
    • A61H2015/0007—Massage by means of rollers, balls, e.g. inflatable, chains, or roller chains with balls or rollers rotating about their own axis
    • A61H2015/0042—Balls or spheres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/01—Constructive details
    • A61H2201/0173—Means for preventing injuries
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/1635—Hand or arm, e.g. handle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5005—Control means thereof for controlling frequency distribution, modulation or interference of a driving signal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5023—Interfaces to the user
    • A61H2201/5043—Displays
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
    • A61H23/02—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms with electric or magnetic drive

Definitions

  • the present invention relates to a method and apparatus for treating pelvic pain in women and men.
  • pelvic pain has long been a problem among women and men.
  • Conventional medicine has treated pelvic pain in various ways including, 1) an organ-specific focus in which pelvic pain is believed to be a symptom of inflammation in the bladder, inflammation or infection in the prostate gland, or pathology of the uterus; 2) focus on the idea of the pudendal nerve being entrapped and needing release; 3) focus on an autoimmune process; or 4) focus supposed on psychiatric problems deriving from a fear of sexual activity, a propensity toward malingering, or neurotic somatization. While all of these treatments have failed to resolve the problem of pelvic pain, an example of one of these approaches is shown in United States Patent No. 2,478,786, which shows a prostate gland massaging implement. In the field of urology, prostate massage derives from the goal of expelling the prostate fluid suspected of containing inflammatory or infectious pathogens, for treating urinary frequency, urgency, dysuria and other related symptoms of bacterial or inflammatory prostatitis.
  • Trigger points When pressed in a specific way these trigger points can release, often attended by a significant reduction or abatement in pain and dysfunction. Trigger points have been found to be strongly exacerbated with anxiety and other perpetuating factors. Trigger point release, particularly for trigger points located on the outside of the body has become a subspecialty within medicine.
  • the inventor of the present invention David Wise, Ph.D, along with his colleague and coauthor Rodney Anderson, M.D., professor of urology at Stanford University, previously described techniques for identifying and manipulating trigger points in their book A Headache in the Pelvis: A New Understanding and Treatment for Prostatitis and Chronic Pelvic Pain Syndromes, which was originally published by the National Center for Pelvic Pain Research in 2003, and is incorporated herein in its entirety by reference.
  • an apparatus and method for treating pelvic pain includes a rod or wand having a handle attached to a straight portion at a first end of the wand and a pressure applicator attached to a second end of the wand, where a first curved portion is disposed between the straight portion of the wand and the second end of the wand.
  • the first curved portion may be substantially semicircular, and may define an arc of approximately 180 degrees.
  • the apparatus includes a wand having a second curved portion disposed between the first curved portion and the second end of the wand.
  • the second curved portion of the wand may form an angle between 45 to 90 degrees with respect to the first curved portion of the wand, and the first curved portion of the wand and the second curved portion of the wand may cooperate to define a reverse curve.
  • the apparatus includes a stop or platform that is adjustably disposed on the wand for adjustably restraining insertion of the pressure applicator into the body cavity.
  • the stop includes a flange that is engageable with an external surface of the patient's body and a collar that is disposed on the wand.
  • a positioning element may be provided on the collar of the stop, the positioning element moveable between an engaged position, where the positioning element engages the wand to restrain movement of the stop with respect to the wand, and a disengaged position, where the positioning element does not engage the wand and does not restrain movement of the stop with respect to the wand.
  • the positioning element may have a threaded aperture formed through the collar and a set screw receivable within the threaded aperture for engagement with the wand.
  • the apparatus may include a pressure sensor and a display electrically connected to the pressure sensor to display a pressure value.
  • the pressure sensor may be disposed in the pressure applicator, or the pressure sensor may be disposed in the straight portion of the wand.
  • the pressure applicator is fabricated from an electrically conductive material, the wand fabricated from a non-electrically conductive material, and the apparatus includes an electrical stimulation unit electrically connected to the pressure applicator for supplying electrical current to the pressure applicator.
  • a trigger point is located in the patient's pelvic floor. With a lubricated glove or condom covering the distal end, the patient inserts the apparatus either vaginally or rectally to allow contact of the pressure applicator of the apparatus with one or more trigger points located on the pelvic floor, and pressure is applied to the trigger point using the apparatus in order to release the trigger point.
  • a hand-held internal therapeutic massager includes a rod having a first portion that defines a curve and a second portion that is substantially straight. The first portion of the rod is adapted to be inserted into a patient's body.
  • a curvature of the curve defined by the first portion of the rod is sufficient to prevent the second portion of the rod from entering a patient's body.
  • a handle is located on the second portion of the rod and a pressure applicator on the first portion of the rod is adapted to be inserted into the patient's body for engagement with a localized area of myofascial tissue.
  • a vibratory device is disposed within the handle and is operable to generate vibrations. The vibrations generated by the vibratory device are conducted through the rod to the pressure applicator to the localized area of myofasical tissue.
  • FIG. 1 is an illustration showing a first embodiment of the apparatus for treating pelvic pain according to the invention
  • FIG. 2 is an illustration showing use of the first embodiment of the apparatus for treating pelvic pain according to the invention by a user
  • FIG. 3 is a partial cross section of the pelvis of the user showing engagement of the first embodiment of the apparatus for treating pelvic pain according to the invention with a myofascial trigger point;
  • FIG. 4 is a side view of a second embodiment of the apparatus for treating pelvic pain according to the invention.
  • FIG. 5 is a side view of a third embodiment of the apparatus for treating pelvic pain according to the invention.
  • FIG. 6 is a side view of a fourth embodiment of the apparatus for treating pelvic pain according to the invention.
  • FIG. 7 is a side view of a fifth embodiment of the apparatus for treating pelvic pain according to the invention.
  • FIG. 8 is a side view of a sixth embodiment of the apparatus for treating pelvic pain according to the invention.
  • FIG. 9 is a side view of a seventh embodiment of the apparatus for treating pelvic pain according to the invention.
  • FIG. 10 is a side view of an eighth embodiment of the apparatus for treating pelvic pain according to the invention.
  • FIG. 11 is a side view of a ninth embodiment of the apparatus for treating pelvic pain according to the invention.
  • FIG. 12 is a side view of a tenth embodiment of the apparatus for treating pelvic pain according to the invention.
  • FIGS. 1-3 there is shown an apparatus 10 in accordance with a first embodiment of the invention.
  • the apparatus 10 includes a substantially j -shaped rod or wand 12, a handle member 14 connected to a first end of the wand 12, and a pressure applicator 16 connected to a second end of the wand 12.
  • the handle member 14 and the pressure applicator 16 are connected to the wand 12 in any suitable conventional manner.
  • the wand 12, the handle member 14, and the pressure applicator 16 may be fabricated from any suitable material, such as acrylic.
  • the wand 12 is a continuous member that has a straight portion 18 that extends from the handle member 14 for approximately ten inches before reaching a semicircular portion 20.
  • the semicircular portion 20 defines an arc of approximately 180 degrees. However, it should be understood that the semicircular portion 20 need not be exactly semicircular, as long as it forms a generally u-shaped curve.
  • the wand 12 may be either hollow or solid, as desired.
  • the wand 12 is substantially slender member, having a diameter of, for example, three-eighths to one-half of an inch, such that the diameter of the wand 12 is large enough to provide sufficient strength to the apparatus 10 to allow the user to apply pressure using the pressure applicator 16 without undue deformation of the apparatus 10.
  • this dimension is considered critical in that the diameter of the wand 12 must be small enough so that rectal insertion of the apparatus 10 does not induce defecation when the wand 12 is inserted rectally by a patient and so that the uncomfortable sensation caused by insertion of the wand 12 does not overpower the patient's ability to sense engagement of the pressure applicator 16 of the apparatus 10 with a trigger point 3.
  • the pressure applicator 16 is a substantially spherical or semi-spherical member adapted for engagement with trigger points 3 in the pelvic floor 4, as will be explained herein.
  • the pressure applicator 16 is sized similarly to the tip of a human index finger (not shown) and is between nine-sixteenths of an inch in diameter and one and one-quarter inches in diameter.
  • the pressure applicator 16 is approximately eleven-sixteenths of an inch in diameter, which allows effective, safe pressure to be applied to the trigger point 3 to cause palpation of the trigger point.
  • This range of dimensions is considered critical in that pressure applicators 16 in larger sizes, such as one inch and seven-eighths of an inch in diameter were tested and found to be unsuitable, as these pressure applicators 16 did not allow sufficient pressure to be applied to trigger points and made locating trigger points 3 difficult.
  • pressure applicators 16 in smaller sizes make palpating the trigger points 3 difficult and can cause excessive pressure to be applied.
  • the pressure applicator 16 could be provided in other non-spherical shapes.
  • the apparatus 10 is a device used for patient's self-treatment of pelvic pain to deactivate trigger points inside their own pelvic floor 4 by inserting the device vaginally or rectally. More particularly, the apparatus 10 of the first embodiment allows the user to access anterior trigger points (trigger points toward the front of the pelvic floor 4, closer to the belly than the back) and perform ischemic compression (pressure that squeezes the blood out of what is being pressed) on anterior trigger points.
  • anterior trigger points trigger points toward the front of the pelvic floor 4, closer to the belly than the back
  • ischemic compression pressure that squeezes the blood out of what is being pressed
  • the apparatus 10 may also be used to stretch restricted, shortened, chronically contracted internal pelvic muscle tissue so that it elongates and reduces in its pain, soreness and ability to refer these sensations.
  • Trigger point release using the apparatus 10 involves finding the internal trigger point 3, which is described in detail in the 4th edition of A Headache in the Pelvis and in Travell and Simon's book, A Trigger Point Therapy Manual, holding it and pressing on it for a period of 30-90 seconds to release it and reduce it's ability to refer pain and symptoms to sites either remote from it or directly at the site of palpation.
  • the trigger point release aims to free the muscles in and around the pelvis of active trigger points 3 and to restore the muscles of the pelvic floor 4 to a flexible and lengthened state.
  • the phenomenon of trigger points was introduced into medicine by Travell and Simon who published the first edition of Myofascial Pain and Dysfunction: The Trigger Point Manual in 1983, which was followed by a second edition in 1992. These books were the culmination of research that went back to 1942 when Dr. Travell published her first article on myofascial pain.
  • Trigger points 3 are specifically defined herein as taut bands within a muscle, either at the surface of the muscle or inside the muscle, in the belly or at the attachment of the muscle.
  • the trigger point 3 characteristically elicits a twitch response, detectable on ultrasound or via electromyograph (a machine that measures the electrical activity in a muscle in millionths of a volt), that can be felt by a trained practitioner while palpating the trigger point.
  • electromyograph a machine that measures the electrical activity in a muscle in millionths of a volt
  • the trigger point 3 characteristically refers pain/sensation to the site being pressed or to a site remote from it.
  • a trigger point 3 can be active or latent.
  • An active trigger point 3 is considered able to refer pain and recreate that pain upon palpation when the patient comes in with a complaint of pain.
  • a latent trigger point 3 has the capacity to be the source of pain (i.e., has the capacity to become an active one) and under certain circumstances, becomes active but generally the patient does not complain of symptoms from latent trigger points.
  • Trigger points 3 are latent in many people. Trigger points 3 refer pain directly on the trigger point 3 site or to a remote site, which means that where pain is felt is often not where it actually is coming from. For instance, testicular pain is often referred from trigger points in the quadratus lumborum. This is not obvious and is anti-intuitive. This trigger point 3 can be around 8-10 inches away from the site of the discomfort. The internal muscles that contain trigger points 3 are often close to each other. The relationship between symptoms and the location of associated trigger points 3 is mostly found in Travell and Simon's textbooks.
  • the patient Before using the apparatus 10, the patient receives instruction on the use of the apparatus 10 by a qualified physician, osteopath, nurse, physical therapist or other designated professional. After receiving competent instruction, the user may use the apparatus 10 while sitting down on a toilet seat, in the lithotomy position lying down with the legs parted, a position commonly used in the gynecologist office when a doctor does a digital vaginal examination, or while the user lies on his or her side.
  • the apparatus 10 is held in front of the patient's body, with the straight portion 18 of the wand 12 extending along the torso of the user's body, toward the user's head, and the pressure applicator is inserted, for example, through the rectal opening 5 and into the rectal cavity 6.
  • One of the user's hands 2a holds the handle 14 and pushes away from the user's body, while the other hand 2b holds the straight portion 18 of the wand 12 of the apparatus 10 near the semicircular portion 20 of the wand 12 and pulls it toward the body, thereby exerting pressure on the pressure applicator 16 of the apparatus 10 at a level of pressure of 1-12 lbs. as measured by the flexion of the straight rod at its tip as it engages the pelvic floor 4, in order to access and palpate anterior trigger points 3.
  • a condom or rubber gloves are always placed over the tip of the apparatus 10 coming up 8- 12 inches and sterile lubrication like KY Jelly® or Surgilube® is used to facilitate easy insertion and removal of the apparatus 10.
  • trigger points 3 All of the internal trigger points 3 must be thoroughly evaluated and treated. When trigger points 3 are located, they are held with pressure release using the apparatus 10 which involves pressing on a trigger point 3 with constant pressure, usually for a period of 30-90 seconds. So that the patient may readily measure the elapsed time during trigger point release, the apparatus may include a timer (not shown) on the wand 12 or the handle member 14 of the apparatus 10.
  • Specific trigger points 3 in specific pelvic muscles tend to refer specific kinds of symptoms. For example, pain in the tip of the penis or the sense of urgency and frequency is typically created by active trigger points 3 in the anterior (front) portion of the levator ani muscle.
  • active trigger points 3 in the anterior (front) portion of the levator ani muscle When a patient uses the apparatus 10, knowledge of the relationship between symptoms and pelvic trigger points 3 is essential to be able to use the wand properly and instructions in the use of the apparatus 10 are part of its proper use and appropriate prescription by a physician or designated health care professional.
  • an apparatus 110 includes all of the elements of the apparatus 10 of the first embodiment as well as an adjustable platform or stop 130 that is disposed on the wand 12.
  • the adjustable stop 130 serves to limit the depth to which the user of the apparatus 110 may insert the pressure applicator 16 into the vagina or rectum.
  • This adjustable stop 130 allows the user to determine how far in to insert the wand 12 in order to accurately find and release internal pelvic floor 4 trigger points 3.
  • the position of the adjustable stop 130 on the wand 12 is adjusted by a therapist who has mapped out the user's internal trigger points 3 and who is teaching the user how to locate, self-treat and release her or his own trigger points 3. This is necessary since the locations of internal trigger points 3 are very difficult to discern, since patients are often incapable of accurately sensing the location of the pressure applicator 16 of the wand 12 once inserted.
  • the user's doctor or therapist may determine the appropriate depth or depths at which the wand 12 needs to be inserted to access the trigger points 3 on which release will be performed by the patient.
  • the user may then identify the trigger point 3 location or locations more easily, since the range of motion of the pressure applicator 16 of the wand 12 is limited by engagement of the adjustable stop 130 with the exterior of the patient's body. Also, by using the adjustable stop 130, the maximum depth of insertion of the wand 12 is limited, thereby reducing the risk of patient injury, such as tissue bleeding, damage or internal organ perforation.
  • the adjustable stop 130 includes a flange 132 that extends radially outward from a collar 134 that is slidably disposed upon the wand 12.
  • the flange 132 lies substantially perpendicular to the longitudinal axis of the wand 12, and is adapted to engage the exterior of the user's body to restrain the apparatus 110 against further insertion.
  • the collar 134 is substantially tubular, and has an internal diameter complementary to the external diameter of the wand 12.
  • a positioning element 136 such as a set screw, extends through a threaded aperture 138.
  • the positioning element 136 moves between an engaged position, where the positioning element 136 engages the wand 12 to restrain movement of the adjustable stop 230 with respect to the wand 12, and a disengaged position, where the positioning element 136 does not engage the wand 12 and the adjustable stop 130 is not restrained from moving with respect to the wand 12.
  • the positioning element 136 of the adjustable stop 130 may be slid along the wand 12 to any desired location on the straight portion 18 or the semicircular portion 20 of the wand 12. Then, when the adjustable stop 130 is in a desired position, the positioning element 136 may be moved to the engaged position to lock the adjustable stop 130 in the desired position.
  • an apparatus 210 includes a wand 212 having a primary curved portion 220 that is similar to the semicircular portion 20 of the apparatus 10 of the first embodiment, as well as a secondary curved portion 222 that is disposed between the primary curved portion 220 of the wand 212 and a pressure applicator 216 that is similar to the pressure applicator 16 of the apparatus 10 of the first embodiment.
  • the primary curved portion 220 forms a generally u-shaped curve and may be substantially semicircular.
  • the apparatus 210 also includes a handle 214 that is connected to a straight portion 218 of the wand 212.
  • the handle 214 and the straight portion 218 are similar to the handle 14 and straight portion 18 of the apparatus 10 of the first embodiment.
  • the secondary curved portion 222 of the wand 212 is positioned along the wand so that it is disposed internally when the pressure applicator 216 is engaged with a trigger point 3.
  • the secondary curved portion forms an angle between 45 to 90 degrees with respect to the primary curved portion 220, and the primary curved portion 220 and the secondary curved portion 222 may cooperate to define a reverse curve.
  • the user may engage the pressure applicator 216 with posterior trigger points 3 (trigger points 3 located toward the back of the body, closer to the back than the belly), such as trigger points 3 on the coccygeus muscles, to perform ischemic compression, milking, or strumming of those trigger points 3.
  • posterior trigger points 3 such as trigger points 3 located toward the back of the body, closer to the back than the belly
  • trigger points 3 on the coccygeus muscles to perform ischemic compression, milking, or strumming of those trigger points 3.
  • an apparatus 310 includes a pressure sensor (algometer) 322 that is disposed within a pressure applicator 316.
  • the wand 312, the handle 314, and the pressure applicator 316 are similar to the wand 12, the handle 14, and the pressure applicator 16 of the apparatus 10 of the first embodiment, respectively.
  • the pressure sensor 322 may be any conventional sensor operable to output an electrical signal corresponding to a sensed pressure value, and thus, the pressure sensor 322 is operable to detect the pressure applied to the trigger point 3 by the pressure applicator 316 of the wand. To provide information regarding the pressure applied by the pressure applicator 316 to the user, the pressure sensor 322 is electrically connected to a display 324 by a cable 326.
  • the display 324 is a conventional digital or analog device operable to display a measured value corresponding to the measurement made by the pressure sensor 322 and thus allows the pressure applied by the pressure applicator 316 to be monitored by the patient during use of the apparatus 310.
  • the display 324 may be disposed external to the wand 312 and the handle 314 in a separate housing, and the cable 326 may extend through the wand 312 and out of the handle 314 to the display 324.
  • the display 324 may be disposed on the straight portion 318 of the wand 312 or on the handle 314. Provision of the pressure sensor 322 and the display 324 allows the patient to apply the amount of pressure to the trigger point 3 prescribed by the patient's doctor or therapist, thereby facilitating effective, safe trigger point 3 release.
  • an apparatus 410 includes a flexible pressure sensor 422 that is disposed within a straight portion 418 of a wand 412, adjacent to a handle 414.
  • the flexible pressure sensor 422 is, for example, a flexible bend sensor that produces a changing output signal, such as resistance, as the degree of bending of the sensor occurs.
  • the flexible pressure sensor 422 is an elongated body that is disposed within or embedded within the handle 414.
  • the flexible pressure sensor 422 is electrically connected to a display 424 by a cable 426, which are similar to the display 324 and cable 326 of the apparatus 310 of the fourth embodiment, respectively.
  • the user places a first hand 2a on the handle 414 of the apparatus 410, and a second hand 2b on the straight portion 418 of the wand 412.
  • a deflection is induced in the straight portion 418 of the wand 412. This deflection is measured by the flexible pressure sensor 422 and, since it corresponds to the pressure applied by the pressure applicator 16, is converted to a pressure reading and output on the display 424.
  • an apparatus 510 includes an electrical stimulation unit 524.
  • the wand 512, the handle 514, and the pressure applicator 516 are similar to the wand 12, the handle 14, and the pressure applicator 16 of the apparatus 10 of the first embodiment, respectively.
  • the wand 512 of the apparatus 510 is fabricated from a non-electrically conductive material, such as acrylic, while the pressure applicator 516 is fabricated from an electrically conductive material.
  • the electrical stimulation unit 524 is disposed external to the wand 512 and the handle 514, and is electrically connected to the pressure applicator 516 by a cable 522 that extends through the wand 512 and out of the handle 514.
  • the electrical stimulation unit 524 is a conventional unit that is adapted to provide electrical current for electrical stimulation of muscles.
  • the pressure applicator 516 may apply both pressure and electrical stimulation to the trigger point 3 using the electrical stimulation unit 524.
  • an apparatus 610 includes a removable pressure applicator 616.
  • the wand 612, the handle 614, and the pressure applicator 616 are similar to the wand 12, the handle 14, and the pressure applicator 16 of the apparatus 10 of the first embodiment, respectively.
  • a threaded portion 622 is provided at the distal end of the curved portion 620 of the wand 612, and a threaded recess 624 is provided on the pressure applicator 616.
  • the pressure applicator 616 may be threadedly connected and disconnected from the wand 612.
  • a plurality of pressure applicators 616 may be provided having various diameters ranging between nine-sixteenth of one inch in diameter and one and one-quarter inches in diameter.
  • the patient may utilize the apparatus with a larger diameter pressure applicator 616 when the trigger point 3 is near the surface, and may utilize a smaller diameter pressure applicator 616 when the trigger point 3 is located deep within the patient's muscles.
  • an apparatus 710 includes a vibratory device 730.
  • the wand 712, the handle 714, and the pressure applicator 716 are similar to the wand 12, the handle 14, and the pressure applicator 16 of the apparatus 10 of the first embodiment, respectively.
  • the vibratory device 730 is disposed within a recess that is formed in the handle 714, which is located at one end of the wand 712 opposite the pressure applicator 716, with the handle 714 extending generally transverse to the wand 712.
  • the vibratory device 730 is operable to generate vibrations.
  • the vibrations generated by the vibratory device 730 can be of various frequencies and intensities.
  • the vibratory device 730 includes one or more control switches 732 to control the frequency (speed) and / or intensity of vibration generated by the vibratory device 730.
  • an intensity of the vibrations generated by the vibratory device 730 can be infinitely adjustable or discretely adjustable between a minimum intensity value and a maximum intensity value using the one or more control switches 732.
  • a frequency (speed) of the vibrations generated by the vibratory device 730 can be infinitely adjustable or discretely adjustable between a minimum frequency value and a maximum frequency value using the one or more control switches.
  • the vibratory device has a frequency that is adjustable from 0 to 180 cycles per second. As will be explained, adjustment of the vibratory device 730 changes the motion induced at the pressure applicator 16, ranging from subtle vibration to a wobbling motion that mimics the manual strumming technique trigger point release therapy.
  • the vibratory device includes an electromagnetic motor that produces vibration as a function of rotation, for example, using an eccentric weight.
  • vibration is produced using a piezoelectric transducer or an ultrasonic device, such as an ultrasonic motor, which produce vibration in response to an electrical signal (waveform) that controls the intensity and the frequency of the vibration that is generated, where the electrical signal is generated by a control circuit of the vibratory device 730.
  • the vibratory device 730 can be internally-powered, such as by batteries, or can be externally powered, by connection, such as a wired electrical connection, to an external power source.
  • the vibratory device 730 produces vibrations that are conducted along the wand 712, which can be a solid rod formed of a resilient material, and through the pressure applicator 716 to deliver gentle vibration to a treatment site, such as a myofascial trigger point of on the patient' s pelvic floor, which is access via a rectal cavity or a vaginal cavity of the patient, as previously described.
  • a treatment site such as a myofascial trigger point of on the patient' s pelvic floor
  • a rectal cavity or a vaginal cavity of the patient as previously described.
  • the vibration generated by the vibratory device can induce a wobbling motion at the pressure applicator 716, especially when low frequency, large amplitude vibrations are generated by the vibratory device 730.
  • This wobble mechanically mimics the method of manual strumming in trigger point release, by which the pressure applicator 716 is moved across the fibers of a muscle, and by adjusting the vibration produced by the vibratory device 730, a finer or rougher wobble can be induced at the pressure applicator 716.
  • an apparatus 810 includes a vibratory device 830 and one or more control switches 832.
  • the wand 812, the handle 814, and the pressure applicator 816 are similar to the wand 12, the handle 14, and the pressure applicator 16 of the apparatus 10 of the first embodiment, respectively.
  • the vibratory device 830 and the one or more control switches 832 are similar to the vibratory device 830 and the one or more control switches 832.
  • the vibratory device 830 is disposed within a recess that is formed in the wand 812.
  • the vibratory device 830 is disposed within the wand 812 adjacent to an end of the wand 812, adjacent to the handle 814, and spaced apart from the curved portion of the wand 812 and the pressure applicator 816.
  • the use and effects of the apparatus 810 are similar to those of the apparatus 710.
  • the apparatus 710 of FIG. 10 and the apparatus 810 of FIG. 11 can both be utilized in conjunction with features previously described with respect to other embodiments.
  • the stop 130 of the apparatus 110 can be incorporated with either of the apparatus 710 or the apparatus 810 such that the stop 130 is disposed between the vibratory device 730, 830 and the pressure applicator 716, 816, and prevents the vibratory device 730, 830 from entering the patient's vaginal cavity or rectal cavity.
  • FIG. 12 is a side view of a tenth embodiment of an apparatus 910 for treating pelvic pain according to the invention.
  • the apparatus 910 includes a wand 912, which is as described in previous embodiments and can include or be used with the various features shown in previous embodiments.
  • a pressure applicator 920 is located at one end of the wand 912. In the illustrated example, a narrowed end 914 of the wand is received within a bore 922 defined by the pressure applicator, and a nominal outer diameter of the wand 912 is wider than the narrowed end and is substantially the same as an outside diameter of a base 924 of the pressure applicator 920.
  • At least part of the end portion 926 of the pressure applicator has a substantially spherical shape, which changes to a frustroconical shape at a transition section 928 that provides a gradual change in diameter for the pressure applicator 920, which can aid insertion and removal of the pressure applicator, thus improving patient comfort.
  • the wand 912 and the pressure applicator 920 are formed separately.
  • the pressure applicator 920 being formed from a low durometer, bio-compatible thermoplastic elastomer material, with the end portion having a diameter of about 0.75 inches, the base having a diameter of about 0.5 inches, and a length of about 1.375 inches.
  • the wand can be formed from a material such as ultem, and have a diameter of about 0.375 inches along the narrowed end, and a diameter of about 0.5 inches elsewhere.

Abstract

La présente invention concerne un appareil de massage thérapeutique interne portatif, qui comprend une tige ayant une première partie qui définit une courbe et une seconde partie qui est sensiblement droite. La première partie de la tige est apte à être insérée dans le corps d'un patient. Une courbure de la courbe définie par la première partie de la tige est suffisante pour empêcher la seconde partie de la tige d'entrer dans le corps d'un patient. Une poignée est située sur la seconde partie de la tige et un applicateur de pression sur la première partie de la tige est apte à être inséré dans le corps d'un patient, pour une mise en prise avec une zone localisée de tissus myofasciaux. Un dispositif vibratoire est disposé dans la poignée et peut fonctionner de manière à produire des vibrations. Les vibrations produites par le dispositif vibratoire sont conduites à travers la tige jusqu'à l'applicateur de pression et la zone localisée des tissus myofasciaux.
PCT/US2014/067551 2013-11-27 2014-11-26 Méthode et appareil pour le traitement de la douleur pelvienne WO2015081161A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US14/091,882 2013-11-27
US14/091,882 US9622938B2 (en) 2007-05-07 2013-11-27 Method and apparatus for treating pelvic pain

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WO2015081161A1 true WO2015081161A1 (fr) 2015-06-04

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2957474A (en) * 1958-05-15 1960-10-25 Wright Arnold G Method of and device for stimulating blood circulation in causing expulsion of retained residual glandular products
US3504665A (en) * 1967-07-10 1970-04-07 Maurice I Bakunin Medical gynecologic oscillator
US5690603A (en) * 1995-09-25 1997-11-25 Kain; Melissa Mia Erogenic stimulator
US5853362A (en) * 1997-06-28 1998-12-29 Jacobs; Deborah A. Glandular stimulator device and method
JP2004181160A (ja) * 2002-11-29 2004-07-02 Hachiro Miura 前立腺マッサージ器
US20090210027A1 (en) * 2007-05-07 2009-08-20 David Wise Method and apparatus for treating pelvic pain

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2957474A (en) * 1958-05-15 1960-10-25 Wright Arnold G Method of and device for stimulating blood circulation in causing expulsion of retained residual glandular products
US3504665A (en) * 1967-07-10 1970-04-07 Maurice I Bakunin Medical gynecologic oscillator
US5690603A (en) * 1995-09-25 1997-11-25 Kain; Melissa Mia Erogenic stimulator
US5853362A (en) * 1997-06-28 1998-12-29 Jacobs; Deborah A. Glandular stimulator device and method
JP2004181160A (ja) * 2002-11-29 2004-07-02 Hachiro Miura 前立腺マッサージ器
US20090210027A1 (en) * 2007-05-07 2009-08-20 David Wise Method and apparatus for treating pelvic pain

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