Ischial tuberosity injection or in buttock for PN?

[DakotaGirl]

Hello. I was just wondering with all the talk of nerve blocks exactly where they should be placed? For instance, most of my pain is at the ischial ligament yet I was told to get a pn nerve block in the buttock because that is where the pn comes out of the sacrum and courses through the pelvis.
Although I had decided for now not to get another injection, I often wonder if they just did an injection at the hamstring insertion level, if I would get some relief from the burning pain there.
I saw in someone's history that they had three injections at the ischial spine. Do they target the area better or not?
What is the point in getting an injection just to see if it gets numb for a short period of time. I would like some anti-inflammatory relief. Is that possible or am I just pipe dreaming?
Thanks. DakotaGirl

[stephanies]

If you receive a pudendal nerve block and still have pain then likely the PN is not the source of your pain, so blocks can help in the diagnostic process. I had one block at the ischial spine, one at Alcock's canal, and one distal to Alcock's. They were all done by different doctors at different places so I don't think there was any rhyme or reason for me. Others might follow a specific protocol.

[DakotaGirl]

Where in laypersons terms are those areas?
Ischial spine =hamstring or sacrotuberous ligament??? Or
Alcock canal=exterior buttock by the crack or above it or below it??
If you could explain kind of where, that would help. And if you got the shot in a certain spot, and no relief then no pn? Even when the Comway emg says abnormal there? I just want to eliminate something. Either the Pn or the Labral tear.
Thank you Stephanie.

[Violet M]

Dakota Girl, I'm not sure what you mean by the ischial ligament.

You can go to the anatomy page to learn where the pudendal nerve landmarks are. http://www.pudendalhope.info/node/13

Here is an image with the basic anatomy:

http://www.pudendalhope.info/node/13#Ba ... ve_Anatomy

Some people get long-term relief from pudendal nerve blocks but I haven't heard of many people who did over the 10 years I've been moderating the forum. I see PN blocks as more of a diagnostic tool than a cure. While they do help some people, some people say they have gotten worse from them.

Violet

[DakotaGirl]

Hi Violet

Thank you for taking the time to answer my question. I guess I don't really know where exactly the stinging pain is coming from but based on those anatomy pictures I would guess sacrotuberous ligamament where the sit bone connects everything.
And because of reading that injections can worsen someone that I didn't dare have any because before knowing it was the PN, I had a piriformis, caudal canal, si joint and hip injection. None of them very telling and no relief either.
thought is if they targeted the sit bone area it would help.

I am not sure either if that is the Alcock canal. I was recently told that the injection can just go into the buttock between the ligaments and the area should be bathed in medicine and that the needle does not need to be specifically targeted at the Alcock canal for instance, because all of the nerve is right there. It's not a huge long nerve -so that makes sense to me.
I hope and pray an answer could help me to determine what to do. Thanks for helping so many people and giving so much of yourself to this forum. DakotaGirl