Great Techniques and Tips that allowed me to Overcome PNE!!!

[rvandenh]

Hi Guys,

I just recently went to a PT Pelvic Support Clinic in Ottawa, Canada as I was suffering from PNE. I was suffering from severe stabbing pains in the perineum, and genitalia areas for over 8 months. Those areas also became very numb, and I began to have impotency issues with my gf. The practitioner there taught me a certain technique how to relax my pelvic floor muscles, and essentially "drop the pelvic floor" allowing the pudendal nerve to be free'd.

The technique is essentially tightening the rectum area only (not buttocks), and releasing/relaxing the muscles upon exhaling. This does take a bit of practice to just squeeze the center of the rectum area only where all your pelvic muscles are located and then letting go and pushing out to relax them. You must do this very often during the day (200 + times). I have found that in two days my symptoms have quickly disappeared, and I have regained feeling in that area as well as the ability to get an erection.

I have another appointment booked with the same practicioner soon, and she will teach me more techniques to relax those pelvic floor muscles which can play a large part in compressing the pudendal nerve. I will let everyone know what else I find out. I strongly recommend practicing this exercise above, and if anyone has any questions with regards to this feel free to respond to this forum.

Other things that have helped me with PNE is taking a small does of amitriplyine 30 mg (nerve stabilizer), as well as do certain stretches at night (side leg raises, supine leg raises, touching your toes, and the sumo pose stretch. Another big thing which has helped me was using a DISCREET donut cusion (can be found online biolectrix) at work, taking pressure off the perineum area. I understand donut cushions can be embarassing, however there are discreet donut cushion out there and your co-workers will never notice it is one.I strongly recommend recommend these type of donut cushions for those who have sit for prolonged periods during the day.

I also tried undergoing shock wave therapy but it had very little effect on improving my symptoms. The pudendal nerve is located deep in the pelvis and I believe these shock wave therapies are unable to effectively reach that area.

I write this is in the aim of helping others with this very scary issue. I'm a 26 year old male, and the experience of having severe pains and not being able to have sex became a nightmare. I had it for over 8 months, and just after practicing the technique described above has quickly given me much hope!! I've done extensive research on this subject, if anyone as anyone questions please let me know.

Wish you all the best,

Robb

[Runnermema]

Hi Robb,
I am very interested to hear about your progress with this pelvic floor physiotherapist in Ottawa. I live in Barrie, On. and I'm seeing a new physiotherapist this week who is a specialist in pelvic floor. I'm wondering what the name of your physiotherapist is so I can pass this information on. This new therapist is very interested in learning as much as possible about pudendal neuralgia in order to help and support me. My pudendal neuralgia seems to be the result of a stress fracture to my pubic ramas and then difficulty or complications in the healing process that initiated nerve irritation and perhaps entrapment. I am previously an active runner and social worker and my world has changed radically with these symptoms. I am also interested in your success with taking amitripyyline as I find my flare ups are often related to intense emotions, and wonder if this particular medication might help. I am already on significant medications and am hesitant to add another one due to likely side effects. Also the massive protocol of medications in trying valiantly to get relief is contrary to my previous holistic lifestyle. I look forward to hearing more about your healing - and work with this particular therapist.
RM

[Violet M]

Robb, I think that's great that in 2 days your pain of 8 months has improved just from some simple exercises. I'm guessing I must have had a different pathology than you because pelvic floor relaxation techniques didn't help and stretching made me worse.

I think that some people have just a tense pelvic floor causing pudendal neuralgia, but don't have a ligamental compression of the pudendal nerve. Whether this is true PNE I can't say for sure because I'm not sure that an exact definition of pudendal nerve entrapment exists. There has been a lot of discussion on the PNE forums on the difference between PNE caused by tense pelvic floor muscles impinging on the pudendal nerve and nerves being compressed between 2 ligaments or entrapped in fascia or scar tissue. It's important to explain this distinction for new people coming onto the forum who can't understand why they don't get better using pelvic floor relaxation techniques such as you described.

Anyway, I wish you all the best in your recovery and would be interested to hear how things progress for you.

Violet

[bma]

A nerve can suffer several injuries:
Neurapraxia, Axonotmesis, Neurotmesis (Seddon, H.J.: Classification of nerve injuries, British Medical Journal, 2:237, 1942). Neurapraxia is a light lesion with symptons of numbness.
http://brachialplexus.wustl.edu/injury.html

People who suffer neurapraxia can improve very quickly. One must understand that bodies are different and a more optimistic approach can be applied to many cases. It's strange, but we seem to forget that the pudendal nerve is... a nerve! and is exposed to the same type of trauma and compressions that other nerves . Its a sensory and motor nerve (as many others). The pain of the genitofemoral, ilioinguinal and hypogastric nerves is terrible, too. Generally a feeling of numbness and sexual impotence characterizes only one type of neurapraxia, which can be reversed with the return of blood flow (ischemic injury).Theres not lose of tissue. Just light compression (such as numbness of the legs crossed, a type of transient neurapraxia).

Nerve trauma occurs from contusion, stretching, or laceration:

Other conclusion from http://www.chiro.org/ACAPress/Periphera ... tries.html:

"Contusion (neurapraxia). Recovery is usually within 6 weeks. Contusion may be the result of either a single blow or through persistent compression. Fractures and blunt trauma are often associated with nerve contusion and crush. Peripheral nerve contusions exhibit early symptoms when produced by falls or blows. Late symptoms arise from pressure by callus, scars, or supports. Mild cases produce pain, tingling, and numbness, with some degree of paresthesia. Moderate cases manifest these same symptoms with some degree of motor-sensory paralysis and atrophy.

Crush (axonotmesis). Recovery rate is about an inch per month between the site of trauma and the next innervated muscle. If innervation is delayed from this schedule or if the distance is more than 6 inches, surgical exploration should be considered.

Laceration (neurotmesis). Laceration follows sharp or penetrating wounds and is less frequently seen associated with tears from a fractured bone's fragments. Surgery is usually required. A traction injury typically features several sites of laceration along the nerve. Stretching injury is usually limited to the brachial plexus."

Nerve Structure:


Sources.:
http://www.fpnotebook.com/ortho/neuro/P ... vInjry.htm
http://brachialplexus.wustl.edu/injury.html
http://www.netterimages.com/image/29567.htm
http://www.orthopaedicsone.com/display/ ... sification
http://www.chiro.org/ACAPress/Periphera ... tries.html
http://www.orthobullets.com/hand/6066/p ... and-repair

[saint]

The myelin sheath around the nerve may have been damaged also. May want to consider phospholipids or lecithin - cheaper.