Why do my pn symptoms disappear while in the pool?

[pizzarios]

Thanks hermajesty. I'm laying here in tears, listening to my husband play with my two young sons in the other room, as I type this.

You insight means a lot. I was athletic prior to pn symptoms. I did tons of yoga and runnung prior to second pregnancy, but was not regularly exercising prior to, and after his birth lasts November. Started back up with yoga 2-3 times. Week, and after a lunging/ hip flexion filled session on the second week after starting, the intermittent pain stopped and constant burning pain began. This was over a month ago.

I have only been to 2 pt sessions, but all she's done was a q-tip test, and bio feedback on my butt. I turned out to have excellent tone etc, so nothing wrong there.... I really want her to dine in and get to work on insides and miofascial stuff etc . I feel like she's dragging things out just to charge me more. My pain is only creeping up worse an worse as h weeks go by and I just want some relief. I am getting so depressed over this. How long do I give it?? Pt I mean? Should I go o omen else??

Do I need to see a pain center or doctor specifically? I'm just lost and I don't have the option to get he necessary scans or blocks at this time... Any suggestions would be helpful.

Thank you all

[Violet M]

Pizzarios, you may have already posted how you found this physical therapist -- was she on our list of PT's and is she trained to treat people with pudendal neuralgia? With your history of exercising/lunging, etc. your PT needs to be someone who can evaluate your pelvic stability/ligaments/alignment, etc. because that type of exercising can strain your ligaments and throw your pelvis out of alignment. Hopefully you are seeing someone who understands the mechanics of the pelvis as well as the complexities of pudendal neuralgia. I have to say biofeedback was totally useless for me so I can understand your frustration if that's all she's doing. If you don't feel like she is giving you the right treatments I think it would be wise to see someone else. Excellent tone isn't typically what patients with pelvic pain need to be concerned about so I'm not sure why she would be focusing on that -- usually PN patient's muscles are overly contracted and tense and the goal is to get those muscles to calm down, lengthen, and relax.

Clonazepam might be helpful for the stabbing pain. Some women have good results with valium vaginal suppositories. I found opioids to be helpful as a short term solution to severe pain while I was searching for the right treatments and recovering from surgery. I did not use time released opioids around the clock and only used percocet or hydrocodone occasionally, especially at night to help me through the evening when my family was home, and to help me sleep. I think that if opioids work for you and other drugs do not, they can help to keep your pain levels lower to prevent your central nervous system from going into "overdrive" and are safe drugs when used as prescribed. If you don't use them around the clock, you are not as likely to develop a tolerance or an addiction to them. I was able to get off of them easily after about a year of using them. Typically opioids are prescribed by pain docs although some primary care docs will prescribe them. If you see a pain doc, you might want to ask before you see them what types of therapies they use for patients with pelvic pain/pudendal neuralgia since insurance is an issue for you.

Violet

[pizzarios]

Violet, you're a doll.
Yes, this person was listed as a pn pt on this very website.
The initial consultation didn't have a thorough examination, just the q tip test, and I was disappointed. I think you're right in saying I should look into seeing someone else.

In terms of pain doctor, I will have to see if they are in network. I wanted to avoid opiates and muscle relaxers but I really thnk my body needs a substantial break from constant pain. It makes caring for my baby and toddler and home VERY challenging. I was dreading taking all of these steps, and now here they are before me. I have never been o scared in all my life.

I'm really grateful for all the help and input.

[pizzarios]

Also,what are the best scans to get in determining if th cause of the
Problem is sijd? Will potter MRI exposé this?

[TriMaverick]

This is an interesting discussion. Not sure if you have had any good info pizzarios, but I have
Yes Tri, I guess ice will only actually relieve inflammation on a newish or aggravated injury? Although it is also soothing for burning/intense tingling.


How do you work out zoned endorphins Tri? I have been so reluctant to go swimming as I used to be fairly good and just think I would get so frustrated 'taking it easy' but if I stuck a float between my legs, I could still get a bit of a workout. Think I am my own worst enemy in that regard.
Take care all,
Helen

My understanding is that with injury inflammation progresses to spasm if not effectively addressed early on heat is the only temperature range effective in loosening the muscles.

In training Zone 2 is the bulk of the aerobic range and is considered moderate intensity. Zones 3 - 5 are hard. Zone 2 might be effective enough for endorphin release; whatever experience brings. I haven't produced a graph (yet). You have pain from swimming?

[pizzarios]

TriMaverick, is zone 2 training essentially just warming the body up just enough through exercise? Do you suppose I should slap in a tube of lidocaine and attempt a jog? My beloved yoga only seems to worsen my pain afterward . Running was my other preferred activity in past life before kids/pain. Do you think it's worth a try? I have not attempted a run since urethral/vulvadynia pain became constant 2 months ago. Is there a link where I might learn more about this zone 2 thing you speak of?

[Karyn]

Also,what are the best scans to get in determining if th cause of the
Problem is sijd? Will potter MRI exposé this?

Yes, a Potter MRI would show tissue damage to the the SIJ. But a regular MRI and/or a CT would also work, too. The first (1.5) MRI I had done picked up on bilateral spurring of the joint and it's ankylosed. The 3T I just had done (not by Potter) picked up (2) Synovial Cysts, the right measuring 7 mm and projecting into my iliacus muscle.

I have only been to 2 pt sessions, but all she's done was a q-tip test, and bio feedback on my butt. I turned out to have excellent tone etc, so nothing wrong there.... I really want her to dine in and get to work on insides and miofascial stuff etc . I feel like she's dragging things out just to charge me more. My pain is only creeping up worse an worse as h weeks go by and I just want some relief. I am getting so depressed over this. How long do I give it?? Pt I mean? Should I go o omen else??

It's apparent you've got a lot going on, hon. It could be that she's trying to take things slowly with you. How often are you going? Your first appointment should have been a thorough evaluation, so an appropriate course of action can be mapped out. Did this happen with you? Did she discuss the findings of the evaluation with you? Any discussion about your SIJ?
Warm regards,
Karyn

[pizzarios]

Karyn, first appointment was just lots of background ( hers and mine ) talking and q-tip test. Did not evaluate my body or the mechanics from the outside. Didn't do it in second appointment either. Hen I suggested possible piriformus probs or pn being the culprit, she just said she thought there a few things going on with me ( she theorized) but in no way elaborated on what those might be. Ian going to call another pt tomorrow. I know she's taking it slow, but to not even examine my frame/build etc?? She can't get things started in two sessions by merely listening to my laundry list of symptoms and causes. Sorry. Just frustrated.

[Karyn]

I know she's taking it slow, but to not even examine my frame/build etc?? She can't get things started in two sessions by merely listening to my laundry list of symptoms and causes. Sorry. Just frustrated.

No apologies necessary. I completely understand your frustration! Really???? No manual exam???? If you (understandably) don't want to give this therapist one more chance, I don't blame you in the least for wanting to consider someone else.
Best wishes to you - please let us know how you make out.
Hugs,
Karyn

[pizzarios]

With regard o the possible SI problem i may have:

I have a friend who can "hook me up" w/a ct or MRI ( not sure if it's 3t ) for FREE . I know it's not the potter, but it will have to do for now. Any recommendations on. "script" for the radiologist?