I have a past history with pelvic floor hypertonicity that has had it's fair share of other problems (vulvodynia, IBS, fissure, etc.). This resolved around 8 years ago after some PT and kind of went away on its own after that. But, it seems to be back in a new. angry form. I have had the worst time sitting for the past six months - right around my coccyx. I did three months of PT with a pelvic floor therapist, but most of it was focused on the SI joint (near the pain point) - and I think this was mostly because I had front right hip pain, as well, and we focused in on that. At the same time, I was seeing a chiropractor. After three months, she sent me to a sports med doctor, who ordered me a pelvic MRI, which of course came back clean.
She then suggested a pelvic rehab center out by me. I did a visit with them. They do not accept insurance. Their diagnosis with pelvic floor hypertonicity with pudendal involvement. Their recommendations are valium suppositories, Cymbalta 30 mg (I'm hesitant to take an anti-depressant for nerve issues), internal pelvic PT work, and ultrasound-guided trigger point injections. The ultrasound trigger point injections are $3900 total out of my pocket. It seems like a lot for something that isn't guaranteed. Has anyone had success with these? I am starting to get more desperate. PT said then she would make appointments for me the day after injections to help lengthen the muscles.
I am visiting Shobeiri soon, as well, for another opinion. I've seen his name floated on here some. I think maybe a second opinion and discussion may give me a better idea on where to go with this and if the $3900 is worth it for me.
Has anyone had both a nerve block and trigger point injections, and if so, was one more effective than the other?
On one hand, if it's the pelvic floor being too tight, I suppose a trigger point injection makes more sense. If it's a nerve issue, then the nerve block does. I just don't know which it is. As mentioned, I do have a past with pelvic floor hypertonicity and vulvodynia, which was resolved with PT, but around the same time I also had meralgia paresthetica.
If only I could get a full pelvic replacement
I'm also wondering if maybe just the internal PT work would help, but the PT seemed to think the pain needed to be managed before continuing with anything.