Instant diagnosis from nerve block possible?
Instant diagnosis from nerve block possible?
After suffering from PNE symptoms for over two years I finally found a Dr. who understood what was going on. He gave thorough exam, ordered CT scan and two dianostic nerve blocks. I had the first block Wed. (with steroids also) and about 5 - 10 minutes after ct guided injection he asked me how I felt. I replied I was starting to get numb in perineal area and he said I tested positive. So all you veterans who may have discussed this subject before, is it possible to reach a conclusion that quickly? Also said he cures about 60% with his blocks and I know how you feel about that? Thanks for your feedback!
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helenlegs 11
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Re: Instant diagnosis from nerve block possible?
I don't want to burst your bubble BUT I would say that the fact that your perineum went numb was just the fact that the injection had hit the required spot.
HOWEVER, if your pain then was less or disappeared once the numbness took effect then that would be a positive diagnosis. I don't know if the injection was preceded with any anaesthetic, as that may also have a numbing effect. That would wear off however and THEN you would be able to properly ascertain (sorry the Dr would
) whether the actual block had worked or not.
Was the block guided btw?
Some people say that they had relief (and that is the biggy) for a few hours, some longer, some forever but probably after more than one.
Your own reaction and your relief from the symptoms are the big diagnostic factor I think.
Hope you did get that relief too, and it lasts
Take care,
Helen
HOWEVER, if your pain then was less or disappeared once the numbness took effect then that would be a positive diagnosis. I don't know if the injection was preceded with any anaesthetic, as that may also have a numbing effect. That would wear off however and THEN you would be able to properly ascertain (sorry the Dr would
) whether the actual block had worked or not.Was the block guided btw?
Some people say that they had relief (and that is the biggy) for a few hours, some longer, some forever but probably after more than one.
Your own reaction and your relief from the symptoms are the big diagnostic factor I think.
Hope you did get that relief too, and it lasts
Take care,
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
Re: Instant diagnosis from nerve block possible?
Thank you for your reply Helen. Yes block was CT guided and I got some pain relief in one area but nothing in buttocks or sit bones. Does each block relieve a different area? It did include an anesthetic. I was just surprised that he could arrive at a conclusion before I even had time to feel the full effect. It's tuff to be a newbie as I don't know what to expect. Sure appreciate those of you who share the info you have gathered and experienced.Judy c
Re: Instant diagnosis from nerve block possible?
Hi Judy,
The anesthetic works pretty quickly so I think what your doctor told you makes sense. I never had complete relief from any of my nerve blocks. The block should relieve primarily the saddle area which is the distribution area of the pudendal nerve. If you have other contributing factors such as piriformis syndrome or SIJD a pudendal nerve block won't necessarily help those.
We don't hear of many cures from nerve blocks around here but some docs are reporting good results. I hope you will be one of the lucky "cured" people.
Violet
The anesthetic works pretty quickly so I think what your doctor told you makes sense. I never had complete relief from any of my nerve blocks. The block should relieve primarily the saddle area which is the distribution area of the pudendal nerve. If you have other contributing factors such as piriformis syndrome or SIJD a pudendal nerve block won't necessarily help those.
We don't hear of many cures from nerve blocks around here but some docs are reporting good results. I hope you will be one of the lucky "cured" people.
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
Re: Instant diagnosis from nerve block possible?
Judy ..May I ask who the dr. was? If he's close enough I may go see him.
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helenlegs 11
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- Joined: Fri Sep 17, 2010 9:39 am
- Location: North East England
Re: Instant diagnosis from nerve block possible?
What did happen a little later Judy? Did you notice any pain reduction with the numbness?
With regard to the buttock I suppose it will depend on what area you actually mean (maybe it's just mine that covers a vast area ) The cluneal nerves innervate the skin on the buttocks, but as Violet mentioned any SIJD or piriformis pain, (also buttock) the shot you had, will not have any affect there. If you are going for any follow up appointments with regard to the injection please specify which area's, the shot did (and didn't) help. Allowing the Dr to see this will be able to help him/her decide where the problem(s) actually are.
In the meantime you could take a look at the anatomy diagrams on the home pages and try to decide yourself where the buttock pain may actually be. Don't worry if you can't, as really that's the Dr's job
With regard to the buttock I suppose it will depend on what area you actually mean (maybe it's just mine that covers a vast area
) The cluneal nerves innervate the skin on the buttocks, but as Violet mentioned any SIJD or piriformis pain, (also buttock) the shot you had, will not have any affect there. If you are going for any follow up appointments with regard to the injection please specify which area's, the shot did (and didn't) help. Allowing the Dr to see this will be able to help him/her decide where the problem(s) actually are.In the meantime you could take a look at the anatomy diagrams on the home pages and try to decide yourself where the buttock pain may actually be. Don't worry if you can't, as really that's the Dr's job
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
Re: Instant diagnosis from nerve block possible?
No Helen the pain relief didn't last after the anesthetic wore off and it was in the saddle area. I will be having a series of 3 or 4 total . Areas of pain in back are buttocks all the way down to mid -thigh with extremely sensitive skin and muscle twitching, Impossible to sit on ischial tuberosities. Also painful genitals but not rectal. I don't yet have a full diagnosis. I'm having adhesion surgery Sept. 17 to see if that helps any.
The neuroradiologist doing the guided blocks is Dr. Westesson in Rochester, NY but I wouldn't be too optimistic about his cure rate estimates just yet. Will let you know my results.Judy c
The neuroradiologist doing the guided blocks is Dr. Westesson in Rochester, NY but I wouldn't be too optimistic about his cure rate estimates just yet. Will let you know my results.Judy c
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helenlegs 11
- Posts: 1779
- Joined: Fri Sep 17, 2010 9:39 am
- Location: North East England
Re: Instant diagnosis from nerve block possible?
How far up the buttocks Judy? Mine is sort of 3/4's up at piriformis level. I have it all down the back of my thigh too. Mine is a very wide ( all of the back of thigh) deep area of numbness. Absolutely completely densely numb but I also get a growing stone/log which is more towards the outside of my thigh and feels like a vice grip . I know this sounds mad!! but that's a nerve madness! Just telling you this because my Dr has diagnosed that the post femoral cutaneous nerve is responsible for this part of my problem. This does make sense as that nerve is responsible for innervation to that wide (in my case anyway ) area. Any sciatic nerve pain would be narrower normally, I believe. Well I have sciatic pain too so I don't really know why I am saying 'I believe' I damned well KNOW!! 
Take care,
Helen
) area. Any sciatic nerve pain would be narrower normally, I believe. Well I have sciatic pain too so I don't really know why I am saying 'I believe' I damned well KNOW!! Take care,
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
Re: Instant diagnosis from nerve block possible?
Hi Judy!
I just had a Pudendal block in Sayre. This was the first guy that actually pressed on the pudendal nerve in such a way he elicited the increase in pain I get when I sit. I got some relief with the lidocaine, but when that wore off the pain came back. I read that any relief even for a few hours is a positive response.
I had gone to the Colo-Rectal Center at Highland Hospital in Rochester and didn't get any positive results. The manometry test did show a constant spasm and Pudendal Nerve damage in 2 areas. So that was when I started googling Pudendal + it was a validation for me after suffering so long with this.
Have you gone to see Dr. Fred Howard out of Strong Memorial? I saw his name on here. I called today and they said I had to fill out a questionnaire before I could make an appointment.
Best of luck to you!
I just had a Pudendal block in Sayre. This was the first guy that actually pressed on the pudendal nerve in such a way he elicited the increase in pain I get when I sit. I got some relief with the lidocaine, but when that wore off the pain came back. I read that any relief even for a few hours is a positive response.
I had gone to the Colo-Rectal Center at Highland Hospital in Rochester and didn't get any positive results. The manometry test did show a constant spasm and Pudendal Nerve damage in 2 areas. So that was when I started googling Pudendal + it was a validation for me after suffering so long with this.
Have you gone to see Dr. Fred Howard out of Strong Memorial? I saw his name on here. I called today and they said I had to fill out a questionnaire before I could make an appointment.
Best of luck to you!
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helenlegs 11
- Posts: 1779
- Joined: Fri Sep 17, 2010 9:39 am
- Location: North East England
Re: Instant diagnosis from nerve block possible?
Hi Barbara,Barbara wrote: I just had a Pudendal block in Sayre. This was the first guy that actually pressed on the pudendal nerve in such a way he elicited the increase in pain I get when I sit.
Make sure to mention this clinical examination in your questionnaire. Obviously mention all of the treatments you have had but this one is a very good illustration that the problem is PN.
I'm sure I am stressing needlessly, as the people you have mentioned do know all about it, I'm sure. It's unfortunate that I have met so many pelvic pain 'deniers' in the medical profession, I am a bit jaded
This has happened even though I too have had an actual diagnosis from an expert .You are definitely on the right track now, Hoorah!
take care,
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.