The Botox Campaign means more options for Pelvic Pain – including Endometriosis.
What’s the Campaign all about?
There are many ways in which pelvic pain can start – maybe with endometriosis, or bladder pain, or an injury – but they all have something in common. When pain continues, the muscles of the pelvis get tight and painful. In the most severe cases, these muscles go into spasm and cramp.
Pelvic Muscle Pain may be a stabbing pain on the sides of the pelvis, or an ache across the pelvis, or stabbing pain up the bowel or vagina, or a pain that goes into the back, or the front of the legs. It’s a pain that can stop you moving, be worse after core-strength training, be worse in different positions, or be worse with prolonged standing or sitting. When someone says ‘The pain came on suddenly, and I couldn’t move’, thats usually pelvic muscle spasm.
If you don’t have pelvic pain, imagine having a cramp on the inside of your pelvis. Stabbing pains, everyday, all day. Waking you up at night. Making it difficult to walk. Nothing that others can see or understand, so embarrassing as well as painful.
Unfortunately, this is life for those people with the most severe forms of pelvic pain. An injection of botulinum toxin in these muscles can stop that pain, and start them on the road to recovery.
Very few people who could benefit from this treatment receive it, as there is no Medicare Item Number for this procedure. Without an Item Number, it is difficult for hospitals and doctors to offer this service.
Botulinum Toxin (botox) is allowed to treat sweaty armpits, hoarse voice, stiff neck, migraines, muscle spasm after stroke, twitchy eyelids, muscle spasm in children with cerebral palsy and now bladder incontinence – but not pelvic pain.
It’s not right and it’s not fair.
The Botox for Pelvic Pain Campaign wants our government to recognise that pelvic muscle pain is important too – to allow those people with the most severe pelvic muscle spasm to have injections of botulinum toxin (botox) in these muscles, as part of their recovery and journey towards less pain.
To do this, we need Medicare to grant an Item Number for Pelvic Pain.
Help us make this Campaign a Success
To spread the word and make this campaign a success:
- Send a friend request to Facebook / Pelvic Pain Hurts
- Follow the campaign on twitter.com/pelvicpainhurts #pelvicpainhurts
- Share the Facebook page and Twitter feed with your friends/Linkedin contacts. We need everyone to know how important this is.
- Download the flyer and put it up at your workplace, or send it to your friends
- Download the Campaign slips to give to friends, or put up at your workplace
- Lobby your local member of parliament. They need to know the effect that pelvic pain has on your life – even if you look normal on the outside
To become actively involved in the campaign:
- Contact Ms Tracy Jones at firstname.lastname@example.org
- Send your stories of pelvic pain to Tracy to forward on to the Medical Benefits Schedule committee. These are the people who make decisions about your pain. They need to know how important pelvic pain is.
I didn’t realise that pelvic muscles could cause pain
Pain in any part of the body usually causes tightness of the muscles around it. When someone breaks their arm, they hold it stiffly. People with a back injury will know that the muscle spasms in that area can be much more painful than the back injury itself.
People who have pelvic pain, get tightness, tenderness, pain and spasms in the muscles of the pelvis – either the pelvic floor muscles that go across the bottom of the pelvis or obturator internus, the muscle on the inside of the hips on each side.
I thought that Botox was just cosmetic
Botulinum toxin is used to treat a wide range of medical conditions including stiff neck, sweaty armpits, cerebral palsy in children, muscle spasm after stroke, twitchy eyelids, hoarse voice, and migraine headache.
Recently our government recognised that it can be important in the most severe cases of bladder incontinence. They provided an Item Number for botox use for this condition, to make it more available for those who need it. This is a wonderful option for those men and women with the most severe bladder problems and we congratulate all those involved.
The problem is that there is no Medicare Item Number for botox use in severe pelvic pain due to muscle spasm.
Our government recently reviewed the Item Numbers for botox use in medical procedures. Gynaecologists, physiotherapists and women with severe pain made submissions for an Item Number, but the request was rejected.
That’s what’s so unfair.
Why are those with so much pain they cannot work or care for their families less important than someone with sweaty armpits? Most of those affected with pelvic muscle spasm are young people where pelvic pain compromises their work, education and relationships.
Without an Item Number, many people who could be helped and lead normal lives will miss out.
What’s the solution?
This problem could easily be solved with either:
- a new Item Number for botulinum toxin for pelvic muscle pain, or,
- recognition that current Item Number 18360 could be used for this condition
Item Number 18360 is for muscle spasm affecting the leg. Spasm in the pelvic muscles can often make walking or even moving difficult. If 18360 applied to pelvic muscle spasm, this would help many of those affected. Currently this Item Number is interpreted as only applying to those people who have had a stroke.
Using Health Dollars Responsibly and Effectively
All Australians have a role in keeping our health system affordable and available for those who really need it. It’s important that health dollars are spent wisely.
Mild degrees of pelvic muscle pain are common, and can be managed well with stretches, pelvic physiotherapy, relaxation techniques and neuropathic medications such as amitriptyline and duloxetine. They don’t need botox to treat their pain. These treatments are all described on this website and are important management techniques for anyone with pelvic muscle pain.
However, for some people these treatments just aren’t enough. Botulinum toxin injections into the affected muscle stop the spasm, start the recovery process and allow them to start working on the lifestyle, physiotherapy and medication options that will give long lasting benefit.
The injection of botulinum toxin is a short day surgery procedure, with no cuts or stitches and the ability to return to work or normal duties within 24 hours. It needs to be done in hospital, as the muscles involved are deep and the procedure would otherwise be too painful.
Botulinum toxin injections provide good value for health dollars, when used in those with the most severe pelvic pain.
This is because sufferers of severe pelvic pain would otherwise undergo frequent and prolonged hospital admissions, with more expensive and possibly dangerous procedures.
The Pelvic Pain Foundation would welcome the opportunity to discuss ways to target this treatment in an economically responsible way.