Did labral tear surgery reduce your PN/pelvic/perineal pain?

[Karyn]

Hi Alexm,

It appears they've taken the site down.

I hope you find this link helpful:

http://www.chiropractic-help.com/maignes-syndrome.html

Best,
Karyn

[alexm]

Thanks for the link Karyn.

Al

[Jennifer L]

Hi Friends,
I had labral repair and bone resurfacing last Feb. I was having pne symptoms and being managing by a pm guy. I just went for a second option because my hip is not better its worse along with the pne. My new hip guy did MRI and CT scan. Today he went over it and says the I still have Labral tears and my hip resurfacing caused a little hook that every time my hip rotates it goes back over my torn labrum. From my first hip surgery my both feet are numb and after surgery no one could touch me on that leg and hip area. Major sensitivity to touch. Prior to surgery I could lay on my back flat. My butt pain and groin pain are worse not better at all. I had more pne symptoms in the vulva area and now more in the back, anal and during bowel movements are like torture. I had vulva pgad prior to hip surgery. This had gotten better besides that it is in my anal area and groin. My new hip guy would like me to get the surgery in a couple weeks. I am so afraid. Is there any surgeon I can send my new results to comparing my hip now to my hip prior to hip surgery. I heard Dr. Coleman may help or I can at least to a consult. I live in Michigan. I don't want to rush into surgery without getting good medical advice from a surgeon that is familiar with pne with the labral repair. The new hip guy won't even put me in water therapy. I have been bedridden since my last hip surgery. So, number one how did I re injury it. When my pne hit last april I was very active. I lifted heavy weights and worked out for a living. I would appreciate any advice. No family members can help. Since my last labral repair cause more damage do I have a case for malpractice making my hip and pne worse? Appreciate any advice. They would like do surgery again in November or January. I don't want to jump into the surgery until I get better medical advice from a surgeon who is familiar with pne and failed labral tears.
Thank you very Kindly,

[DakotaGirl]

Hi Jennifer,

I am no expert on any of this as it is all new to me but i wanted to say my heart goes out to you for all you have been through. It is especially discouraging to feel even worse after surgery.
The only thing I wanted to say was that I too have a torn labrum with a bone spur type of impingement. I went to a specialist in hip arthroscopy at one of the top hospitals in Boston recently for an evaluation for surgery.
What he said, was that labral repairs in people over 40 don't have enough successful outcomes to warrant surgery. He is doing a research study on surgery vs pt for labral tears.
Of course I didn't participate in the study, but did try pt one time already and it seemed to flare the pn. I also went to internal pt that night and that flared the pn.
I think what I was trying to say is if you ended up worse after one surgery, then really think about a second. Is this second one to repair the initial one or to shave down the bone?
I just wonder what the answers are when it's so complicated.
One last note, when I had a gallbladder surgery many years ago, I ended up worse for over a year and never thought it would heal but in time it did. Please don't think I am saying this to patronize you as I feel your confusion anger and pain as I am going through the same mind blowing pain and confusion too. I often think if I had the damned hip repair would the pn go away. There's just no easy answer and I truly hope you find some solace and relief. DakotaGirl

[Antonia]

Just an update and question:

I had surgery for this 7 mos. ago, but got terrible post op pt, keeping the pelvis more in play and the core less so (still very weak there). It was fine in terms of pelvic pain though, up to a certain point where the pulling at the pubic bone was too intense. I ended up with steroid injections, which I had a severe adverse reaction to, at the muscles attaching to the pubic bone but didn't react the same to them as I had before. It was excruciating, and I have been relying on ART (active release technique) for release of the muscles, but had developed a compensation of clenching at the sacrum. After the injections, the entire pelvis went into spasm, especially at that area, and every time I get an ART treatment (which works surprisingly well) I am told that it's the pudendal nerve trapped up and irritated in these muscles that are spasming since the injections.

What on earth do you do when the pudendal nerve is in play like this? I haven't a single doctor to see about it (I'm scheduled for two pain management docs, one general and one pelvic), can't take drugs for nerve pain or anything like that and am scared of any other procedures. I've read of cases where the pudendal issues were resolved through ART, but what do you do when one minute it was fine and the next the muscles all go crazy along with the pudendal nerve? Until insurance approves pelvic floor therapy as a separate condition, I have no ability to even have it treated in that way. I need some pudendal hope right now!! If it can unflare and come back due to muscular & steroid issues, surely it can unflare again.....has anyone gone through this with just muscle clenching in that area causing the nerve to flare or steroid induced neuropathy?

Thanks;)

[Violet M]

Antonia,

Maybe you could try some vaginal valium to see if it relaxes the muscles. B&O suppositories might help temporarily to get you through the flare-up. Using vaginal suppositories doesn't' give you as many systemic side effects so you might be able to tolerate drugs that way. If it's muscle tension you could try Botox but that's invasive and carries more risk. You could also try ice or heat -- or alternating both. I used to sit in tubs of hot and cold water.

How long ago were the steroid injections that caused the reaction? It's not unusual to have a temporary flare-up from steroid injections.

Violet

[Antonia]

I got the injections Oct. 22, but had several others in Sept. My system got so overloaded I ended up in the ER 4 times for vertigo, dizziness and the severe amount of swelling and bruising to the genitals from the shots. And thrush and other infections from my immune system being blasted. I don't really have anyone to give me vaginal valium....waiting to get into a pelvic pain specialist, but this was so out of nowhere. It flared the muscles up, mainly in the back and at the sacrum, compensating for the painful front (seriously, my genitals were black & blue for almost 2 weeks from this, all of the swelling & bruising went right there). Then the hip and all the muscles related to the hip (obturator internus, piriformis, etc., I'm sure everyone here knows them well). I haven't had any pelvic pain or genital pain at all since surgery in April, other than the general soreness of surgery and all.

What risks does botox carry? I don't really want any other shots after this disaster of the injections, especially as I was fine in these area before that! I was able to get into my previous pelvic floor therapist, but insurance won't go ahead and approve the visits yet so I wasn't able to go. I've done ART and that likely flared it a bit, but is releasing the muscles. Twice now, once just a few minutes ago, I've gotten up to walk and had pain just shoot to the front left so bad I felt like I'd vomit or something. Has anyone here tried ART?

So flare ups are common with steroids? I was literally given no risks or warnings at all, told I'd have minor soreness at the injection site. It blew up my genitals and flared up my joints and muscles, which had been in good shape, then made the pelvic floor go completely nuts, all the muscles around the hip and the hip itself. The hip hasn't felt like this since 1 month post op, and the muscles around it haven't felt this way, well, ever....a different pelvic pain doctor (who happened to be a jerk) did inject a trigger point in the obturator pre-op, and cleared it up. Now they're all just clenched so bad I can't manage to unclench them. This is such a nightmare. Why does it have to shoot to the genitals? OMG!?!?

What do they do for the pudendal nerve? When I posted here before, no one was sure whether or not it was that, and it turned out to not be then. Now, well, it definitely is. I cannot take nerve pain meds, nor seizure drugs. I can't take psychotropics either, actually. No amitriptyline or gabapentin, those have been offered so far...nothing stronger either. It'll have to be other methods. PF therapy? ART? Can these help?

Sorry, that was a horrible feeling, this shooting pain that happens. Thank you for answering, Violet.

[Violet M]

Sometimes it takes a month or two for the flare-up from injections to calm down. Since you can't take drugs maybe the ice and heat or pool therapy would help get the muscles calmed down. I don't know.. it seems a bit risky to try any other kinds of injections like Botox or nerve blocks right now. It's hard to predict how you might react to them. Maybe some physiotherapy would help -- if you can find someone who knows how to do it without flaring you up. My understanding is that ART can be a bit rough but I haven't tried it myself.

Violet

[Antonia]

Yes, I don't want any other injections or meds, this is bad enough. I got the muscles calmed down a few days there, felt a bit better, then was up doing things finally, and it flared right back up, glutes hard as rocks. Just agonizing pain to the pubic bone and if I press anywhere where it hurts in the muscles in the back where the pudendal is, it just shoots right to the front left. No pelvic pain at all for 5 months post op, then it just hit like crazy again, worse than ever. The second I was cleared to walk and started doing it.

My PT was useless (my 7th since surgery, all useless), just told me to go to the ER instead of assessing. Then to go back get treated by my muscle surgeon. Got the steroids, got back in agony and with vertigo and dizziness with various infections and she told me she always advises her patients to never get steroid injections. I fired her today. She didn't return a call for over a week after escalating my pain to include the pudendal nerve. Every PT I go to makes me worse....I'm starting to think this is just hopeless. Working on just relaxing the muscles best I can. This is utter agony, as I'm sure everyone here understands all too well.

Thank you Violet.

[Violet M]

Antonia, maybe you could try some gentle massage therapy and warm water therapy to try to calm things down and then work into some slow gentle movements to try to strengthen the pelvic area without causing a flare-up. Alternating hot and cold water therapy is very soothing too. These therapies have helped some other people including me, but it does take time.

Violet