Posterior Tibial Nerve Stimulation (PTNS) is a medical intervention primarily used to treat certain conditions related to pelvic floor dysfunction, such as overactive bladder (OAB) and urinary incontinence. When performed in physical therapy, the technique involves dry needling with gentle nerve stimulation, and is utilized in conjunction with other nutritional, behavioral, and pelvic floor physical therapy techniques to address specific issues and treat the patient holistically.
Here's a brief overview of PTNS:
Procedure: PTNS involves the insertion of a thin needle (dry needle) near the ankle, targeting the posterior tibial nerve. This nerve runs along the inside of the ankle and is a branch of the sciatic nerve. A mild electric current is then passed through the needle to stimulate the nerve. This should not be painful and intensity is tailored by your PT based on your feedback.
Mechanism of Action: The exact mechanism by which PTNS works is not completely understood. It is believed to modulate neural pathways involved in bladder function and control. The stimulation of the posterior tibial nerve may impact the sacral nerve plexus, which plays a role in controlling bladder function.
Frequency and Duration: PTNS in many settings is typically performed as a series of treatments, usually once a week for several weeks. Each session lasts about 30 minutes. At WWPT, we believe in treating the whole person. Rather than having you attend sessions each week specifically for PTNS, we will combine many other techniques for addressing the issue more holistically. Many women do not require weekly visits and are able to use their PT program to maintain improvements made in-session, stretching sessions out to every other week or longer.
Indications: PTNS is commonly used to treat overactive bladder (OAB), urinary urgency, frequency, and urge incontinence, but I have found it also has remarkable benefits for bladder pain/interstitial cystitis symptoms as well. It may be considered when other conservative treatments, such as behavioral therapies and medications, have not been successful or are not well-tolerated.
Effectiveness: Research has shown that PTNS can be effective in improving symptoms related to overactive bladder and urinary incontinence. However, the degree of improvement varies from person to person, likely due to the complexity of each individual person and the likelihood that other issues require attention as well. This is why we combine PTNS with other treatments in PT and do not single it out as an individual session.
It's important to note that the decision to use PTNS and its integration with physical therapy should be made based on an individual's specific condition(s) and after consultation with a healthcare provider. Physical therapists and urologists often collaborate to develop comprehensive treatment plans for individuals with pelvic floor dysfunction, overactive bladder, and bladder pain.
If you're interested in learning more about PTNS, pelvic floor PT at WWPT, and how may be able to help you with your concerns, book a FREE 30 minute discovery call and we can discuss your issues in more detail.