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8 Comments

  1. Michael Durtnall on May 13, 2020 at 12:50 am

    Pelvic floor pain successfully treated by Sayer Clinic
    Post by Gill T

    I have suffered for many years from stress/anxiety related IBS but in recent years, when having to also cope with the menopause, I have learnt how to manage this fairly successfully.
    However I have also had bouts of pelvic pain, which I had not experienced before, mainly on the left side of my lower abdomen which my GP (after receiving a negative faecal immunochemical test), put down to more IBS symptoms. This lasted a couple of (worrying) months and just when that seemed to have improved I got a bad UTI at the beginning of April 2019, having not had one for about 9 years. However whilst anti-biotics seemed to clear up the infection (i.e. burning symptoms on weeing, blood in urine etc), I continued to have pain in my lower abdomen and the genital area, as well as a continual “tingling” sensation similar to sexual arousal and still feeling I wanted to pass urine.

    My GP insisted that my dip test did not show any infection and said that it was just taking my bladder time “to settle down”. He gave me some anti-spasmodic tablets and told me to take ibuprofen and paracetamol. Unfortunately these made no difference to the pain (and in fact the ibuprofen just triggered my IBS again!) so I returned to my surgery at the end of April. The lady GP I saw did a vaginal examination (I have a slightly prolapsed bladder – after the birth of my first daughter I had a posterior and anterior vaginal prolapse which was repaired about 12 years ago but had not been entirely successful). Nothing unusual was found and she mentioned the possibility of Painful Bladder Syndrome which could have been triggered by the UTI. I started to restrict my diet cutting out all the good things in life like caffeine, chocolate, anything with sugar etc. and started doing some research into PBS However this made me more anxious and I was finding it difficult to sleep so I requested a referral to a urologist (luckily I have private health cover with my job so this was quite quick). I was also concerned about my repair operation as I recalled seeing mention of the use of mesh but I did not know for certain whether it had been used.

    The urologist was very thorough – doing a full culture urine test, urine flow test, cystoscopy and kidney scan. Whilst I was not able to fully empty my bladder, he said that it was very unlikely that I had PBS as my bladder did not appear irritated and he had no other concerns. Meanwhile I had obtained my hospital notes and these confirmed that no mesh had been used in my prolapse repair which was a big relief.

    However the pain and the burning/tingling sensation continued and was really starting to get me down. I sought the advice of a nutritionist and continued with my new diet but had to effectively put my life on hold – just managing to struggle into work and back with the odd day off when the pain was too unbearable, or if I hadn’t slept. Since I was due to take my mother on holiday for a week at the beginning of June for her 90th birthday, I went back to my GP who prescribed tramadol but had no explanation for my pain.

    The tramadol helped with the pain to a certain extent but I only took it in the evening as it made me feel quite woozy. However I managed to get away with my Mum and found the break helped with the anxiety which I am sure now was a contributory factor. The pain was also more limited to my genital area and seemed to be worse after sitting for any period of time (we were on an organised trip so there was quite a bit of sitting on coaches).
    When I returned home I went for a follow up consultation with my urologist who organised a vaginal ultrasound and CT scan. The former was normal other than identifying urine retention but the CT scan came up with mild diverticular disease and mild dilatation of left ovarian and parauterine veins suggestive of pelvic congestion syndrome, both of which I was told could explain the abdominal pain I had experienced.

    However in between having the CT scan and getting the results I had returned to the internet and researched my symptoms again (which were now restricted to pain in my genital/urethra/perineum area). I discovered the terms, pelvic floor dysfunction, pudendal neuralgia and PGAD (persistent genital arousal disorder). My search also led me to the role of pelvic floor therapists who undertake both internal and external manipulation – this in turn led me to Sayer Clinic in Kensington, in particular Michael Durtnall.

    I booked an initial session with Michael and I can honestly say that, after months of just “existing”, this was the turning point. He knew exactly what I meant when I explained my symptoms and, clearly being an expert in his field, he was very matter of fact which made it easy to discuss what are very personal issues! He took a standing X-Ray of my spine and pelvis/coccyx and undertook an internal examination as well as some initial manipulation/treatment.
    Effectively he said that my pelvic floor muscles were incredibly weak and had therefore shortened which was the main cause of the pain as they were compressing the nerves. This was not helped by the fact that my coccyx was quite stiff so wasn’t moving as freely as it should when sitting, hence causing more tension in my pelvic floor muscles. With hindsight I realise now that this had been a problem that had been building up for years since having my children, having a stressful desk job with long hours, having scar tissue from pelvic surgery and, although I did exercise in the form of walking, dancing and horse riding (the latter may have been a contributory factor especially after a fall), not looking after my pelvic floor muscles. I can only assume that the inflammation caused by the UTI was the “trigger” and the subsequent stress/anxiety would have only served to increase the tension in that area.

    Michael also diagnosed the tingling / sexual arousal feeling as a form of PGAD.

    After that first session I felt that a weight had been lifted and the treatment also gave me some relief from the pain. Michael is very much against pain medication and I haven’t touched any tramadol since. I also bought the book by Amy Stein who had been part of Michael’s training in pelvic floor therapy (Heal Pelvic Pain) which I would thoroughly recommend if you are suffering from any form of pelvic pain. I find just doing the “letting go” exercises have been a great help.

    I had a couple of more sessions with Michael during which I had 90% improvement in the PGAD and I then continued weekly physiotherapy sessions with Karolina who, as well as internal massage/stretching, instructed me in core and pelvic floor strengthening exercises to carry out at home. At the same time I have found walking helps relieve my symptoms so I have tried to increase the amount I walk at home and at work I always now go for a walk at lunchtime, as well as having a sit stand desk.

    It has not been easy especially since there is a fine line between doing pelvic floor exercises to try and strengthen the muscles but then overdoing this resulting in increased pain! Sometimes I would go a couple of weeks with very little, manageable pain and then suddenly it would start up again which can really get you down mentally. Each time Michael and Karolina have been there to explain quite clearly that this is perfectly normal in the recovery process and I have discovered that it is definitely true that a positive attitude really does help.

    I have now had months of only mild or no pain and I have learnt to recognise when the tension is building up and which stretching exercises etc I can do to relieve this. I am still seeing Karolina but only every few months and I am now about to start Pilates classes which hopefully will give me more encouragement to increase my core and pelvic floor strength.

    Michael likes his percentages and I can now say that I have 100% improvement in the PGAD and about 90-95% improvement in the pelvic pain.

    Whilst I know I have to be considerate of my pelvic floor health for the rest of my life, at least I now feel equipped to deal with it thanks to Michael and Karolina.



  2. Michael Durtnall on May 13, 2020 at 12:19 am

    Pudendal pain treated by Sayers Clinic
    Post by Isabel

    I am just writing a message to share the improvement I have experienced.

    After childbirth I struggled with pain in my urethra and vagina – very sensitive on skin contact and ruinous for my sex life.

    After months of getting nowhere on the NHS I found Sayers clinic
    I have been going about three months, seeing Dr Michael Durtnall and Pelvic therapist Marta Dias de Oliveira in tandem.

    It has involved intensive manual manipulation of the muscles around the pelvic area. It is tough to have such intimate treatment but the positivity, care and professionalism of Michael and Marta has been a real source of strength to me. I have improved dramatically – all of the skin irritation has gone and I have regained sexual function.

    Their approach is something that needs to be discussed more widely in the medical community, because it seems to work – and its results when it does are life changing.

    Follow-up note to Michael ….

    I am now fully recovered from vulvodynia and coccydynia is so slight as not to affect my day to day. The excellent news (which I couldn’t have dreamed of when I first met Michael – in chronic pain and without being able to have sex) is that I’m pregnant.

    It was with great regret I didn’t get anywhere on the NHS. If you have the money, spend it at Sayers to get your physical and psychological health back.

    Thanks, Isabel.



  3. Michael Durtnall on May 13, 2020 at 12:05 am

    Two years on and still pain free.

    Post by christine – first posted on http://www.pudendalhope.info

    A couple of years ago, I was in constant, excrutiating pain for 4 months and couldn’t find a doctor to help me to relieve the pain in the pelvic area.
    After a lot of research, I found Michael Durtnall MSc DC FRCC in London who treated me. I was only able to see him 6 times before leaving for Europe for a few months, therefore I was wondering how the Pudendal neuralgia would progress when I was abroad.

    By the time I left London I already felt much better after the sessions I had with Michael, but was unsure how some pain I was left with would evolve.
    The truth is that 3 to 4 months after the last session, I was completely free of pain and the symptoms never came back again! I wrote a note on the Pudendalhope website two years ago to tell my story, but I’d like to assure people who go through this pain that the condition I had never came back again.



  4. Michael Durtnall on May 12, 2020 at 11:57 pm

    My pudendal neuralgia recovery with Sayer Clinics

    Post by eebergen – originally posted on http://www.pudendalhope.info

    My name is Elizabeth and I am 39-year-old woman from Norway. I had been struggling with IC and PN for years without finding any help. I lived with an unbearable pain for years, I could not even sit for 5 minutes. In the end, I could not even lay down or stand without pain. Life was unbearable and I just wanted to finish it. After a lot of searching online I found the Sayer Clinics.

    I contacted them and had a session with Dr. Michael Durtnall. He took digital X-rays and performed a careful examination of me. The Sayer Clinics treatment method consisted of specific manual mobilisation techniques to regain and improve the range of motion of my pelvic floor including deep tissue massage, per vaginal trigger points and myofascial bodywork.

    My team consisted of Dr Durtnall who is a direct but also soft person who says exactly what to do and is an optimist second to none. He sees you as a person, not a patient, and helps you through all the phases of recovery. I got a lot of help to understand what was going on inside me, the fight or flight and an oversensitive nervous system and what to do when I got home.
    Marta Dias De Oliveira and Sofia Pinto, and Karolina Krzaczek , Senior Pelvic Pain Physiotherapist who are experts in their field and are extremely competent and warm persons who listen to you and see you as a person.

    The team followed me after my visits with emails and phone calls and are an amazing team of therapists.

    Today I can sit and live an active life without being afraid. It goes up and down like in everyone’s life, but today I’m so much better than I was a few years ago. Fear is the worst enemy and makes everything worse.

    The Sayer Clinics made me not to afraid anymore and dared to live again. Dr Durtnall and his team are incredible and I am forever grateful for his help. I thank them for living today. 😀

    Warmly, Elizabeth



  5. Michael Durtnall on May 12, 2020 at 11:08 pm

    My Pudendal Neuralgia Vulva Hell: Treatment with Dr Durtnall.

    Post by Jane Smith – First posted in http://www.Pudendalhope.Info

    At the age of 15 I had the constant feeling that I needed to pass urine, or at least that is what it felt like. I had the constant desire to try and pass urine even when there was none there. This caused a large amount of discomfort and led to multiple doctors’ appointments that resulted in being prescribed 3 types of antibiotics for various urine infections even though no infection ever appeared in a sample. During this time the pain in my vulva increased, until I was so uncomfortable that being at school was difficult and passing urine made me cry.

    My condition deteriorated quickly, the pain was almost unbearable and I stopped attending school. I was put on multiple strong painkillers which numbed some of the pain but made me lethargic and dazed. Once a urine infection was ruled out as a cause I was transferred to the gynaecology department at the local hospital. They were unsure what the problem was. During the next few months I had an MRI of my spine (not including my coccyx) and a biopsy on my vulva. All of these things caused me a lot of upset, physical pain and were fruitless.

    Once the gynaecologist could not work out what was wrong he became angry and often said that I was clearly making this up for attention, or that I was lying about my virginity. At this point I was terrified, nobody knew what was wrong with me and I was being accused of inflicting this debilitating pain on myself. I was lonely, cut off from all my friends and in pain all of the time. As well as the pain in my vulva I began to feel it in my coccyx, my groin and my abdomen.
    From then I was transferred to a dermatologist who said that it was clear my problem was eczema, after weeks of trials and tests with no improvement I was transferred to the Orthopaedic department. At this point I was bed bound, barely eating and honestly wanted to end it all. I had forgotten what it was like to not be in pain. My vulva felt like it was burning and was red raw (or as my doctor described it, it looked like a “volcano of doom”). My groin ached and felt like something was crawling underneath my skin. My abdomen throbbed and I was constantly cradling my tummy trying to hold it all together. Passing urine hurt and my bowels became painful and erratic. At this point it felt like the doctors had given up and my appointments got further and further apart as I was passed around departments who had no idea what to do with me.
    I was now in unbearable pain, had missed months of school, lost all contact with my friends, been told it was all in my head and had to hear multiple times that there was nothing anyone could do to help. This “mystery” aliment was having a massive effect on my life but also on my family. My sisters barely saw me and when they did I was on too many very strong painkillers to engage with them and in too much pain to leave my room, let alone the house. I’d keep them up at night with my crying and their lack of power to help me scared my younger sisters and frustrated my elder one.

    My sister and mum searched on line for hours for answers, they looked at every forum, every help site, every odd bit of advice. We tried everything but were at a complete loss. Then one day my sister came across Dr Durtnall’s Sayer Clinics website. They read the information about vulvodynia and sacroiliitis and everything clicked. All the pain, all the symptoms that seemed unconnected and had baffled all my other doctors were now being explained and made sense. We made an appointment for the next week and my mum and dad helped me into the car. I cried all the way to London, wincing over every bump in the road. It had been months since this whole ordeal had started and I had completely given up hope, but my sister was adamant that I try Dr Durtnall out. When I arrived my mum filled out a form and we went in for my appointment. As soon as we began talking to Dr Durtnall it was clear he was listening to everything I had to say and made no judgements of me.

    Dr Durtnall’s investigations showed evidence of previous injury to my coccyx, with sacrococcygeal joint retrolisthesis, one-sided sacroiliitis and pudendal nerve entrapment with inflammation in my bladder, vulva, lower abdomen, inner thighs and groins. At 15, I had no idea what any of this meant but it was such a relief to finally have an answer and to be looked after by someone who finally knew what was wrong with me and a possible cure.
    I visited Dr Durtnall twice a week for a month and he treated me with sacro-coccygeal and sacroiliac joint manipulation, giving me regular exercises to do. Within weeks I was feeling much better, I was able to move again, the pain was less constant and I was able to wean myself off all the pain killers I was on. I finally looked more alive again. I continued to visit Dr Durtnall for two years, with my appointments becoming less frequent as I became stronger.

    It is now 6 years since this happened. I sat my GCSEs on time, I took my A levels, I went to university, I have trained as a teacher and I have just started my first job. I have been able to get my life back and to return to normality. While I have had some relapses in between, I am now much better and know exactly what to do when the symptoms return.

    If any of my story sounds familiar to yours, firstly I am very sorry, no one should have to suffer with such pain, and secondly please don’t give up, find people who can help and if you can, visit Dr Durtnall.

    While I was sceptical at first that anything could fix my problem, I dread to think what would have happened if I had not gone to see him when I did.



  6. Michael Durtnall on April 7, 2020 at 10:48 pm

    Review for Dr Michael Durtnall – 10 out of 10!!! Post by Chiara – originally posted in Pudendalhope.Info website.

    Having struggled with PN and only recently correctly diagnosed with Pudendal Neuralgia (PN) I have gone through a number of specialists and pain clinics to no avail. I saw 2 gynaecologists, 2 urologists, 3 neurologists, and went to 2 different pain clinics all across two different countries to no avail. I had lost hope and was feeling incredibly depressed.
    I thought I would be in pain forever.

    And then one day I found Dr Michael Durtnall – he gave me hope that life can be normal again! I can confidently say that he gave me my life back!

    I will provide a detailed account of my experience with Michael, but first and foremost I would like to say that Michael has been the only person so far who understood what I was going through and took into account a number of health conditions which I was never properly diagnosed with. I have seen Michael in total 6 times so far and I am happy to say that he has been able to reduce my Pudendal Nerve (PN) pain by 50%!!

    I went to see Michael with very strong and debilitating PN pain and accompanying back, shoulder and hip pain. Very differently to what other chiropractors/ physio therapists ever did, Michael looked at the composition of my whole body, took comprehensive scans of my spine, neck and pelvis with a state of the art scanner and produced a full body image where I could, for the first time in my life, see that my spine was incredibly twisted. I also had a big leg length difference and my pelvis was twisted too. Michael diagnosed me with quite a severe case of kyphoscoliosis, protruding spinal disk in the lower back area, leg length difference and Pudendal Neuralgia. He was the first ever specialist who explained to me how the spine and legs connect to the pelvis, and how a twisted pelvis can lead to pelvic pain, including PN. I started having treatments with Michael which include various spinal manipulations, pelvic and coxyx bone manipulations, pelvic floor stretches (internal and external) and pelvic muscle releases.

    Every time I walk out of Michael’s clinic I can breathe again, walk tall again and feel recharged with hope that life can be enjoyed again. Not only his treatments work, but he is an amazing human being whom you can talk to knowing he would understand. Most specialists I saw before Michael suggested to me that I should have nerve blocks done and take drugs for the neuropathic pain. Both of those treatments are risky and have really unpleasant side effects. I refused to have nerve blocks administered as there is no substantial proof that they help, and they hold a small risk of damaging surrounding pelvic organs. I was on Lyrica for a while before I saw Michael which didn’t help with the pain either. Michael is the only person who never dismissed what I said and listened carefully to all of my symptoms.

    In addition to the treatments Michael has been an invaluable source of advice as to what I should be doing/ not doing outside of his treatment room – how I should pay attention to my posture 100% of the time, how I should minimise sitting and if required, how to sit correctly and what support to use. He has provided guidance on what exercise I should/ should not do, how to walk, and even what to avoid while having sex.

    Michael is incredibly knowledgeable and experienced in what he does. He performs his treatments with confidence yet gentle approach and respect. I could not recommend Michael enough to anybody who suffers with PN pain.

    Thank you, Michael, for letting me have hope, for making it possible for me to enjoy life again and for making me taller! 🙂 🙂 🙂

    DR Michael Durtnall – YOU ARE A STAR!



  7. Michael Durtnall on April 7, 2020 at 10:38 pm

    Post by Leah87

    I had my first check-up of 2019 and the first appointment I’ve had in a while with Dr Michael Durtnall at Sayer Clinic in London last week, so I thought now would be a good opportunity to take stock and share some positive vibes to kick off the new year.

    So I was diagnosed with chronic pelvic pain 12 years ago. It started with vulval pain upon physical intimacy and inserting tampons. I had suffered a series of infections (BV, thrush, UTIs) so I went to the GUM clinic, where I was told that I had vulval focal pain syndrome. They gave me lidocaine gel, pregabalin and amitriptyline but no positive advice about the future and left me feeling my pelvic floor and vagina would hurt for the rest of my life. We’re super lucky now that there are so many online resources for chronic pelvic pain sufferers. Back in 2007, there wasn’t as much information available, so I was buffeted from neurologist to psychologist to physiotherapist with no results.

    I finally stumbled across the names of Liz Rummer and Stephanie Prendergast, pioneering physical therapists in San Francisco. I flew out to their clinic in 2009, and when I got back I sought treatment from acupuncturist Stefan Chmelik who in turn recommended Dr Michael Durtnall.

    Dr Durtnall examined me and assessed my pelvic pain from my muscles, joints and nerves. My pelvis was very tilted causing a spinal curvature and I had strong and unequal spasms and tension in the muscles of my pelvis right through from back to front which was upsetting my pudendal nerves through the whole of my pelvic floor. I also had pain in my inner thighs, hips and groins. Michael’s pudendal path release treatment and manipulation for my sacrum, coccyx and pelvic floor improved me by 90% in two months.

    Even more than just an amazing, incredibly knowledgable medical professional, Michael is a super positive, compassionate person which really makes all the difference–part of getting better is believe that YOU CAN DO IT! In the early days when all the doctors and physios were telling me I would never get better, I totally internalised that. And it wasn’t even true! I still struggle with my pelvic health, especially during time of stress e.g. Over Christmas, hence my recent appointment, so it’s important to keep on top of flare ups and book in regular check ups. I am just so grateful for the improvement in my quality of life, I’m even engaged to a wonderful partner now, something I could never have imagined back when I thought my sex life was over forever!

    So if you’ve exhausted all your options I really do encourage you to book in with Dr Durtnall at Sayer Clinics. Wishing you all a happy and healthy new year 🙂



  8. Michael Durtnall on April 7, 2020 at 10:32 pm

    Here’s a summary and update Of my treatment with Dr Michael Durtnall at Sayer Clinics since 2017

    Over the past five years, after a fall on the coccyx, I’d developed severe pelvic pain, discomfort, and a relentless need to use the bathroom without ever feeling any relief. I had shooting pain down my leg when I walked. I always had nausea and indigestion, sometimes I could barely keep food down. I had chronic shoulder pain, blinding sudden migraines and numbness in my hands. I got several vague medical diagnosis including; IBS, Chronic Fatigue Syndrome and Gastroparesis, which led to a long and futile list of medications; Buscopan, metoclopramide, codeine, diazepam, omeprazole, tramadol, citalopram and micralax, to name a few.

    I had an inkling that my long list of issues was somehow connected to my spinal/pelvic problems – I had been seeing chiropractors on and off with varying degrees of success, and although none of it lasting, it proved my theory. I was sure it was all connected, but no one seemed to be able to piece it together, so I took the mild relief I got from adjustments and tried to manage as best as I could.

    In late 2016, after reading a lot of reviews, my then partner took me for treatment at Sayer Clinic. I met Dr. Durtnall and immediately the experience was unlike any other I’d had with a medical professional. He immersed himself in everything he did, x-raying me and assessing every aspect of my spine and posture. He told me that I had Pudendal Neuralgia. Finally, this odd, embarrassing, and life-ruining set of symptoms had a name. Over the next few weeks I went to see him religiously, we worked on my pelvic floor, my posture and muscles, and unbelievably but surely, the symptoms started to dissipate! Years upon years of agony, started to dissolve with every visit.
    As I write this now, a few months later, I am essentially SYMPTOM FREE. The slight twangs I have here and there are mere drops, to the ocean of debilitating pain and suffering I used to experience. My life absolutely revolved around symptoms, they governed every part of my day, and now I’m slowly starting to think about other things aside from pain meds and going to the toilet!
    Dr. Durtnall is a leader in this field, and an authority on this subject, no other clinic in London has this level of comprehension when it comes to the spine, pelvic floor, and Pudendal Neuralgia.

    Update (2019):

    Three years on my symptoms have dwindled to nothing. It’s hard to believe now that my life was so dominated by PN for so long.
    I’ve been to see Dr. Durtnall again sporadically over the past three years, whenever I have the odd (rare) flare up, and even then, symptoms are very mild and extremely short lived.
    My days no longer revolve around waking up hideously early, hours before everyone else, to use the bathroom (several times with no relief), doing back and neck stretches, and waiting for pain meds to kick in. I’m rid of all the weird rituals, my daily routine is completely ‘normal’ now and I take no pain medication at all.
    I’ve managed to get my life back; I have a job, I go wherever I want, eat whenever I want, sit on whatever sitting surface is available, without fear of debilitating pain. I can exercise (with great care regarding my posture). I’ve learned a great deal about spines, pelvises and nerves, I take care of mine as much as possible, and hopefully I’ll never be back there again.
    I’m updating this post to let you know there is hope. This is a horrible condition that can really put a dent in a person, but it can be overcome. I can’t recommend Dr. Durtnall and Sayer Clinic enough, this 180 change wouldn’t have been possible without them.

    I wish you all relief from PN.

    Marwa x



  9. Michael Durtnall on April 7, 2020 at 10:12 pm

    I share my story as it might be of help for PN sufferers. There are 9 years since my TVT (tension-free vaginal tape) surgery for wrongly diagnosed urinary incontinence, when they pierced or irritated my left branch of pudendal nerve. Since then, I was in a roller coaster: sometimes in agony, sometimes feeling ok, even practicing yoga. During these years I took different painkillers, I had a decompression surgery in Zurich with prof. M Possover in 2012. Last year was the worst one, the pain was so bad that I had tramadol 3 times daily plus other painkillers and, in addition, I called ambulance a couple of times for IV treatment. I had acupuncture for 3 months, I had many sessions of neuro-modulation therapy with a Scrambler device, I tried hyperbaric oxygen and ozone therapy but what really worked for me was the therapy I got in Sayer Clinic in London (https://www.sayerclinics.com/) At the clinic, I got treatment from Dr M. Durtnall and pelvic pain physiotherapists Sofia and Marta. It was painful and uncomfortable but it worked miracles for me! It was the very first time when things happened exactly how the doctor told me they would. Indeed, for the first week after the therapy, I felt a bit down but slowly I started to feel better and I reduced gradually the painkillers. I received the treatment in september and then in november and now I am so happy and grateful to tell I no longer take tramadol or other painkillers. Equally important, I have learned from these amazing people to pay attention to other symptoms in my body, to my emotions and my thoughts and to the relation between them, to be more kind and gentle with myself. So, so grateful!