Letter Sent to Physician about Psoas Release

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Mods, please feel free to move this to a more appropriate forum. The letter is lightly edited to protect the doctor’s privacy, etc.

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I read your article about psoas release with great interest. Please read this email as a cautionary tale.

I had a THA in 2009 that got infected. After the second washout surgery, I woke up with the only 10/10 pain I’ve ever experienced (I once had a spinal headache, and I would rate that 9/10 when I was standing or sitting). The 10/10 pain lasted about 40 minutes; the chronic pudendal pain was more like a 6/10, perhaps a 7/10 (*).

The pain was constant, unrelenting, and 24/7/365, for 13 years. Yes, I’d call it “suicide-level” pain. As any normal person would do, I grasped at straws, trying procedure-after-procedure, including an endoscopic psoas release (using a cautery device at the lesser trochanter) which did nothing.

In 2022, I finally got a physician to believe me that I had pudendal neuralgia (I had suspected this in 2011, but nobody would listen to me). Yep, it was entrapped between the sacrotuberous and sacrospinous ligaments, and now I’m better.

And I’m also left with astonishing weakness in my right psoas (which I assume cannot be reattached - I haven’t even bothered to ask anyone).

If the pain is intractable, no matter what you do, it isn’t the psoas! Pudendal nerve entrapment should be on the tip of your tongue for any patient who appears desperate, complaining of some deep, unrelenting, burning pain in their pelvis.

(*) Having been through the wringer for 13 years, I can say IN MY CASE that my PN was only about a 6-7 out of 10. On MY PERSONAL pain scale, anything above an 8-9 would render anyone incoherent, and unable to do anything except roll around on the ground, screaming. That said, a constant 6-7 is indeed more than enough to cause suicidal ideations over the long haul.

[Violet M]

If I understand correctly, I think this was a letter you sent to one of your doctors, right? Thank you for educating him/her about PNE surgery.

I went back and read some of your posts and it sounds like you are doing better after your PNE surgery from Hibner in Sept 2022. I hope you continue to do well.

Violet

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Hellllllooooooooo Violet!

Thank you for writing. This was actually a letter which I sent to a physician (whom I respect, but whom I don’t know).