...meds not working

Discuss different Pain Management Options; Medication options including side effects and Worldwide variances in names etc.
pizzarios
Posts: 41
Joined: Tue Jul 10, 2012 8:47 pm
Location: United States

Re: ...meds not working

Post by pizzarios »

Ok, So I went and saw a PT (listed on this very site) who actually studied with the PN PT lady experts in San Francisco. My first appointment was yesterday. She did an exam, and internal work - essentially put pressure and "irritated" the pudendal nerve, to see what was doing. I didn't have much pain/irritation at the time, but last evening the clitoral pain/itching started. This is a new sensation, as my problems have primarily been urethral burning and urgency. The pain today is as bad as it's been so far, with essentially the entire vaginal area feeling inflamed. As a side note, I saw 2 other, less pn knowledgeable PTs prior to seeing this lady, and nothing they did or prescribed as homework, initiated any pain.

I ask you, seasoned PN-ers, with PT history -

DOES PT USUALLY HAVE TO MAKE IT HURT OR GET WORSE, BEFORE IT GETS BETTER??

DOES THIS POST PT PAIN INDICATE THAT SHE KNOWS WHAT SHE'S DOING, OR THAT PN IS ACTUALLY WHAT I'M DEALING WITH??

ps: She suspects in addition to pn, also some bladder and urethral prolapse, both grade 2. YAAAAAYYYYY!!!!!! :\
Not officially diagnosed. Pain began following MANY typical pn causing activities.
Intermittent IC type pain started 5/20/2012
Urologist said IC - did diet, meds etc with no improvement
Constant pn type pain and burning started 7/1/2012
Gp rx gabapentin & lidocaine, no improvement
Started PT 7/23/2012. pelvic MRI that showed osteitis pubis. PT miofascial on inguinal & psoas, pn pain greatly reduced. hip joint/lumbar pain started. 12/20/2012 - Hip MRA shows labral damage.
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helenlegs 11
Posts: 1779
Joined: Fri Sep 17, 2010 9:39 am
Location: North East England

Re: ...meds not working

Post by helenlegs 11 »

I know that many people post about a flare up from PT sessions. I would give them a ring to get some definite feed back, but what you have said above is not unusual. The PT will obviously know where they have targeted and your post session reactions to their therapy will probably give a good indication of how to proceed. Hope the additional pain diminishes quickly tho'
Will the pain management Dr target medication or coping strategies or both? Here's hoping that you get some advice that will work for you. Let us know what they both say.
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.
Budgie
Posts: 17
Joined: Thu Sep 23, 2010 12:34 am
Location: UK

Re: ...meds not working

Post by Budgie »

Hi Pizzarios. Hope things are improving for you. What Helen said in the last post is absolutely correct. Physio can and often does flare things up before it settles again. I've been having physio in the UK for some years now and that nearly always flares things up for a day or so afterwards. Hang in there, it will improve if it hasn't already.

Have you been to see the pain management doc yet?

Neil
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Violet M
Posts: 6714
Joined: Mon Sep 06, 2010 6:04 am
Location: United States
Contact:

Re: ...meds not working

Post by Violet M »

Pizzarios,

Liz and Stephanie have a blog that tells what a good PT session should look like.

http://www.pelvicpainrehab.com/blog/201 ... sion-like/
http://tinyurl.com/cmomsuf

The PT's listed on the website are not endorsed by the HOPE organization. Even though they have had specialized training, as with all providers, there will be great ones and mediocre ones and I have no idea where yours fits in. From my own experience, my first PT session with internal work was incredibly painful and left me with such a nasty pain flare-up I felt instinctively that it was not going to work for me. I had been exercising heavily and I think that the nerve was impinged on by a ligament and PT just irritated it further.

Some people prefer to put off surgery as long as possible and in that case it would make sense to continue with PT to see if it will eventually help you. Some people do get better after trying PT for awhile. For PNE pain, I did not find it very helpful.

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.
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