Pudendus or Piriformis and tingling sensation into both feet

[Violet M]

My PT said to massage the pelvic floor muscles gently, swiping your finger in the shape of a C. Internal pelvic floor work just caused flare-ups for me because I had a nerve entrapment, but it helps some people with tense muscles. Have you seen a pelvic floor PT yet?

Violet

[Filofax]

Update on my situation:
On March 24, I saw a neurologist and was prescribed Gabapentin for unexplained neuropathic pain. I take this 3x 600mg and it has helped me so far. I rarely had any symptoms and the frequency of urination has decreased. I had a much better life and the problem of cpps disappeared into the background. Actually, I should slowly stop taking the medication starting in the fall. Then in September I had a herniated disc L5/S1 and severe pain. That overshadowed the whole thing. After I reduced the pain through physiotherapy and exercises, the Cpps problem came back. In addition, the heating in the office was out and the cold gave me constant pain. In the morning it was only 10-15 degrees in the room and we heated with a hot air blower. The doctor said I should increase Gabapentin every 3-4 days, up to a maximum of 3600mg. I am now at 2700mg and unfortunately it no longer has any effect, but I do have side effects. I get sick and become very mentally unstable. I've also had kidney grit again for a long time, which irritates my urinary tract. For that I take Blanel so that it dissolves and it is part of my problem. After urinating, it burned again for a long time and the pain became very severe again. What could help me? Does Gabapentin become ineffective over time?

[Violet M]

I'm sad to hear that your pain has gotten bad again. I have read that gabapentin can lose its effectiveness over time, but I haven't seen any scientific studies confirming that. Your pharmacist might be able to answer that question. You could try some other medication such as pregabalin (lyrica), duloxetine (an SNRI antidepressant), or buprenorphine which is a narcotic that doesn't cause a tolerance to build up. If your pain is primarily burning with urination, you could try a tricyclic antidepressant medication such as amitriptyline or an SSRI antidepressant. If you have tense pelvic floor muscles, you could try baclofen.

Violet