Pelvic floor tension myalgia (PFTM) is increasingly noted in patients with chronic pelvic
pain. Pelvic floor physical therapy is typically utilized and is at times combined with other
therapies such as botox injections, trigger point injections or pudendal blocks. The
investigators' study will randomize newly diagnosed patients with PFTM to weekly physical
therapy with weekly pudendal blocks or placebo saline injection. Participants randomized to
physical therapy with placebo injections that have a visual analog scale score of greater
than 4 at 6 weeks may cross-over to the pudendal block group. Final patient assessment will
be performed at 6 months to assess durability of response.
Primary hypothesis: The addition of pudendal blocks to standard pelvic floor physical therapy
will result in lower pain and pelvic floor muscle tension scores, lower baseline vaginal
pressure and increase pelvic floor strength.
Secondary hypothesis: The addition of pudendal blocks to standard pelvic floor physical
therapy will result in a lower pain score in a shorter time frame, resulting in faster
progress through physical therapy.