Straining with little result
You feel you're pushing correctly, but the outlet feels blocked and more effort doesn't move things.
You push, but the outlet feels closed, and more effort doesn’t help. Afterward it can feel like you haven’t finished, which leads to repeat trips and long stretches on the toilet. Pressure or aching in the pelvis can build through the day.
Pelvic floor dyssynergia is a coordination problem. During a bowel movement, the belly should push while the pelvic floor and anal sphincter relax. In dyssynergia, the pelvic floor tightens or braces instead. Tight muscles and tender spots often keep that pattern in place.
Diagnosis and retraining usually come from your GI doctor and a pelvic floor physical therapist. I treat the tight muscles that make letting go harder, using dry needling, a form of acupuncture. A tight pelvic floor and obturator internus can crowd the pudendal nerve and its rectal branches. Needling them gives the nerve more space. The aim is a calmer baseline so retraining holds.
Most people have tried fiber, stool softeners or laxatives, and have had imaging or a colonoscopy. These are important for ruling out other causes. Softer stool can still be hard to pass if the pelvic floor braces. Kegels, exercises that squeeze the pelvic floor, and hard core work can add tension to muscles that are already too tight. You may already be doing biofeedback or pelvic floor PT. Needling adds something different, because New York does not let PTs or chiropractors dry needle.
I start by asking about your bowel habits, how long you strain, and what testing you’ve had. Then the exam:
Your GI doctor, colorectal surgeon, urogynecologist, primary care doctor and pelvic floor PT each play a part. Should anything I find point back to one of them, I’ll flag it for you and share my notes.
Not exactly. Constipation is a symptom, and dyssynergia is one possible cause where the pelvic floor and belly aren’t working in sync. Constipation can also come from slow bowel movement, medications, diet or structural problems. Anorectal manometry, a pressure test of the rectum and anal muscles, helps sort this out.
Yes. Coordination problems don’t show up on a colonoscopy or routine imaging. A normal result is still valuable because it lowers concern about structural disease.
No. PT is often central to diagnosing and retraining dyssynergia. My work runs alongside it, easing the tight muscles that can make retraining and home practice harder.
I needle the pelvic, hip and inner thigh muscles that are holding tension. Softening the obturator internus also relieves pressure on the pudendal nerve that serves the rectum. I also look at the breathing and bracing habits that feed the pattern.
It depends on how long you’ve had symptoms and whether you’re also in PT. I set expectations after your first exam and adjust based on how you respond.
See a doctor promptly for rectal bleeding without a known cause, black or tarry stools, fever or unexplained weight loss. The same applies to new severe constipation, persistent vomiting or severe swelling of the belly. New bowel or bladder leakage, numbness in the saddle area, or worsening weakness also need urgent care.
Adults with pelvic floor, nerve and orthopedic pain, along with neurological conditions. Most of my patients come to me after other care hasn't fully settled things. If you're looking for general wellness acupuncture, I'm not the right fit.
We review your history and what you've already tried. I assess the muscles and nerves involved, and you're treated the same day.
It depends on the condition. Pelvic and orthopedic plans usually run 4 to 6 weeks. Neurological plans are usually 2 visits a week for 6 weeks or 3 a week for 4. After that, visits space out so the changes hold. These are typical timelines, not promises.
Yes. I work alongside doctors, physical therapists and specialists. If something I find needs a closer look from one of them, I'll tell you.
I'm an out-of-network provider. You pay at the time of your visit, and my office submits the claim so any reimbursement comes to you. Free benefit checks are available before your first visit through the verification form, and HSA and FSA cards work. I don't take Medicare or Medicaid, though some Medicare Advantage plans reimburse out-of-network care. Full insurance details
Yes. I treat adults, teens and children, though I don't specialize in infants or toddlers.
Yes. Book a free discovery call to ask your questions and see whether we're a good fit.
Dry needling is a form of acupuncture. Fine needles go into tight bands of muscle and trigger points to lower muscle tension and change how the area is signaling.
You may feel a brief twitch or a deep ache as the needle reaches tight muscle. It passes quickly, and any soreness afterward usually fades within a day or two.
It's generally safe with a properly trained practitioner. Needles are sterile and single-use, and I check your health history first, including blood thinners. In New York, dry needling can only be performed by licensed acupuncturists, MDs and DOs. Physical therapists and chiropractors aren't permitted to perform it.
Eat something light beforehand and wear loose clothing that lets me reach the area being treated.
Usually not. Ultrasound helps in a few specific cases, but it hasn't been shown to improve results for common trigger points. A careful hands-on exam is what guides the needle. More on ultrasound-guided dry needling
Dry needling aimed at the pelvic floor and the hip and abdominal muscles around it, for pain, tension and urinary symptoms driven by those muscles and their nerves. More on pelvic floor dry needling
Sometimes, depending on the muscles involved, and you'll be draped throughout. Treatment always follows your consent and comfort. I don't do internal exams or internal treatment.
No, though it helps if you've already seen a doctor or pelvic floor physical therapist. Bring any notes or imaging you have.
Completely. I've heard it all, and there's no judgment here, just a straightforward conversation so we can treat what's going on.
Yes, I treat adults of every gender and identity. After gender-affirming surgery involving the pelvis, bring your surgical notes and we'll decide together what fits.
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Evidence-based acupuncture and dry needling on the Upper West Side. From chronic pain and headaches to pelvic floor dysfunction, Dr. Jordan Barber pairs the highest level of training with care that actually listens.
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