Nerve Block or PT first?

[BlueMagic2020]

Hello,

I am 6 weeks postpartum and my OB as well as an experienced PT believes I have pudendal neuralgia. I had a vacuum assisted vaginal delivery and now I have a severe stabbing pain in my clitoris when I sit in a certain position, stand up from laying down, and pee. I also have a mild pain in my clitoris when pushing a bowel movement. The pain worsens throughout the day. When I sit a lot during the day, I will feel a dull ache just laying down at night. The PT told me to avoid sitting for a few days and it always helps on that particular day. It's not a permanent fix though, I can't just not sit down forever.

I am seeing a urogynecologist next week, who my OB says can administer a nerve block. I've read multiple stories on this forum about how a nerve block made symptoms worse. Any thoughts on whether a nerve block is a good idea? I am only 6 weeks PP and willing to wait longer if there is any chance this will heal on it's own. Has anyone ever healed without treatment? or just with PT? Is the nerve block worth it?

My muscles are extremely tight so I am leaning toward trying PT first. On an emotional note, I am just trying not to fall apart right now. I knew that childbirth would be painful but I just didn't expect daily stabbing pain in my clitoris as a long term side effect.

Let me know your thoughts, thanks all

[Alper61250]

Hi
No nerve block.
I became worse after it in June

[stephanies]

Hi,

I suggest gentle PT and if it increases pain after 6-8 visits, discontinue. If a block increases pain it is usually temporary. Since it has only been six weeks, you could also wait a few months and avoid the things that aggravate your pain and see if you feel better before any type of intervention.

Stephanies

[BlueMagic2020]

Thank you both for your suggestions!

I will hold off on the nerve block for now since the pain is not 24/7. With a new baby around I don’t think I could mentally handle the pain being worse, even if temporary. As for PT, I am leaning toward light exercises as mentioned. I’ll get the doctor’s opinion when I see them next week and make a final call. I’ll post an update in a few weeks in case my story is helpful to anyone.

Thank you again!

[BlueMagic2020]

Hi all who are reading this!

Good news, the pain associated with my childbirth-created pudendal neuralgia has diminished significantly with PT (as well as time in general). At this point in time I am only feeling slight pain while urinating, and it’s not every time. I am still sitting on a cushion with a hole in the middle while working. I do it as a precaution, it may not be needed. I am now 3 months postpartum.

My PT suspects the pain is from a catheter that was placed 1-2 hours AFTER the birth (it was so painful..my body was so swollen....). She said that sometimes your muscles tense up from the trauma and then don’t go back to where they were before and this causes a lot of irritation for the nerve. She worked out a ton of knots in my pelvic region and I began to feel better pretty quickly. I have had 4 sessions and do regular at home exercises.

My mental state was so bad when the pain was at its worst. For those of you out there suffering, there IS hope! I saw 4 different doctors who didn’t at all know how to help. It was the PTs who really knew their stuff (Pelvic Health and Rehabilitation Center = excellent!) I never received a nerve block and I do think this was the right move for my situation (thank you previous posters!).

Best wishes to all you readers out there <333