Pudendal stretch injury

[carolynm]

....has anyone thought of this as their mechanism of injury? Since my symptoms developed 1 day after swinging a pickaxe, this could be a likely cause for me. Doesn't sound like there's much treatment, of course.

Any opinions would be appreciated. Hope everyone is having a low-pain day.

cari

[Faith]

Normal vaginal childbirth would be an example of a stretch injury as the pudendal nerve is stretched 2x it's normal length in childbirth. Typically though people don't have problems more than a few hours/days with PN type pain from this. And some has been known to go on as long as 3 months. I think I heard this in a video on you-tube by Dr. Vancaillie (Austrailia).

I think SIJD would also be an example of a stretch injury as if the joint is out of alignment the ligaments can be pulling on and stretching the nerve. However, I personally believe that after having SIJD for so long it is very likely the nerve becomes entrapped in scar tissue from constant ligament stretching/pulling on the nerve. Just my theory.

I think you can have a stretch injury without having entrapment but the key would be the PN symptoms don't last more than a few weeks to 3/4 months maybe. With an entrapement however, the pain would continue.

[Karyn]

Hi Cari,
Not sure about the pudendal stretch injury, but I don't think you're far off the mark. Doreen (Quilter2) recently had unilateral surgery with Dr. Conway. Her pain started after chopping wood. Come to find out, she actually had a tear in one of her ligaments (?), which formed a significant amount of scar tissue - entrapping the PN.
Sorry to be vague, but she doesn't remember which ligament and we're awaiting her op report. I know she's not on the computer much right now, but I am sure she wouldn't mind receiving a PM from you.
Warm regards,
Karyn

[carolynm]

Hmmmm... Karyn.....this makes me think a little more. I wonder if the torn ligament could have been seen on the Potter MRI? That could have been EXACTLY the same type of case as mine.

I'll have to think about this and possibly call Dr. Potter to ask if she can see a tear, I would think she could.

cari

[Karyn]

Well, in Doreens case, Dr. Potter did not pick up the tear. What she noted was something like, "prominent thickening of the (ST?) ligament". So, I guess that's understandable if after the tear, dense scar tissue developed, encasing the nerve. Hopefully, Doreen will get her op report, soon.

[Violet M]

Cari, I think that a pudendal stretch injury contributed to pain in my case. Originally my pain was fairly mild and had pretty much gone away but I was doing some stretching exercises that a PT recommended and suddenly PGAD hit and soon developed into full-blown PNE pain. I think if the nerve is entrapped and you stretch or bend, it causes a stretch injury to the nerve.

[Karyn]

Hi Cari,
Just wanted to let you know - Doreen did get her op report. Her ST AND SS ligaments were encased in scar tissue, entrapping the PN. The clitoral branch of the PN was also entrapped.

[carolynm]

Thanks for getting back to me on this one, Karyn. And thank you all for your responses. Just doing a little brainstorming.

cm