Why does sitting increase PN pain?

Many physical activites such as sports, pelvic surgery, etc can all contribute to PN
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Lernica
Posts: 960
Joined: Fri Jan 14, 2011 10:31 pm

Why does sitting increase PN pain?

Post by Lernica »

What are the mechanics of the pain? Is it because an entrapped nerve cannot slide away when you sit (like the buttock muscles do)? Is it because the nerve is inflamed and sitting puts more pressure on the nerve and thus increases the inflammation? Is it (as Pianogal has suggested on another thread) because when sitting, the nerve is stretched? Any answers would be welcome. I realized when trying to explain my condition to family and friends that I don't really know the answer to this most basic question.

Thanks.
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
JeanieC
Posts: 198
Joined: Tue Sep 21, 2010 11:47 pm

Re: Why does sitting increase PN pain?

Post by JeanieC »

Lernica,

My understanding is that the nerve is stretched when you sit, if it is entrapped. I remember my surgeon saying that he moved my nerve to where is would "have more slack" in it when I sit and bend.
Diagnosed with left side PN by Dr Renney, March 2010, after over 2 years of searching for help
Left TG Surgery, Dr Ansell, August 2010, failed to relieve pain
Lernica
Posts: 960
Joined: Fri Jan 14, 2011 10:31 pm

Re: Why does sitting increase PN pain?

Post by Lernica »

So if the nerve is not entrapped, does it move out of the way when you sit?
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
RJR
Posts: 155
Joined: Mon Nov 15, 2010 11:26 pm
Location: Northern VA

Re: Why does sitting increase PN pain?

Post by RJR »

My understanding from talking to docs and PTs and reading journals: when we move, sit, etc., nerves are supposed to be able to glide thru existing tunnels or passages thru tissue, muscle, ligaments, etc. When a nerve gets entrapped or compressed (by a ligament, for example), it no longer can freely glide with movement, or sitting. Since it can no longer glide, it stretches, causing it to be irritated. And when nerves are constantly irritated, they start firing abnormally and increasingly in frequncy. Our brains interpret this as pain.
RR
Cyclist till perineal pain onset R side (Apr'08). Dx with PN (Aug'09). Lyrica gave 30% pain reduction. Potter MRI (Oct'10) validated at surgery with Dr Hibner (Nov'10) - found nerve attached to scarred STL. Now sitting 10 hrs/day vs 1 hr/day pre-op. Occasional MRI-guided steroid injections by Dr. Jan Fritz at Johns Hopkins. Surgery video = http://www.youtube.com/watch?v=6FDwana6SQU

Deep neuropathic burning pain flares have been gone since surgery...Grateful to Dr Hibner.
Lernica
Posts: 960
Joined: Fri Jan 14, 2011 10:31 pm

Re: Why does sitting increase PN pain?

Post by Lernica »

Ahhhh! This makes sense. Thanks, RR.
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
Paula
Posts: 3
Joined: Fri Feb 25, 2011 2:32 am

Re: Why does sitting increase PN pain?

Post by Paula »

Does anyone else experience temporary relief while sitting by bringing your feet up/in to sit cross legged position? Nearly impossible to do in a small chair. I have tried to understand how this nerve feel so stretched if my body is in an "L-shape" but not so much if I am in a pretzel. I just can't stay that way very long
Lernica
Posts: 960
Joined: Fri Jan 14, 2011 10:31 pm

Re: Why does sitting increase PN pain?

Post by Lernica »

I can sit on large soft chairs with either my feet tucked under my butt, or with my feet curled up to one side. Either way, I am much more comfortable sitting with my feet on the chair rather than the floor. I imagine that this is because with the feet tucked up on the chair, pressure is taken off the perineum.

RR, if the sitting position stretches the nerve, why is sitting on the toilet often pain-free?
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
RJR
Posts: 155
Joined: Mon Nov 15, 2010 11:26 pm
Location: Northern VA

Re: Why does sitting increase PN pain?

Post by RJR »

From what PT's have told me - the nerve is not "double-crushed" on a toilet. When we sit on a hard surface/chair, one crush is in the sitting position, and the second by the pressure of the surface. Remember, an irritated nerve (eg trapped and can't glide) fires more impulses. Maybe someone has heard better explaination.
RR
Cyclist till perineal pain onset R side (Apr'08). Dx with PN (Aug'09). Lyrica gave 30% pain reduction. Potter MRI (Oct'10) validated at surgery with Dr Hibner (Nov'10) - found nerve attached to scarred STL. Now sitting 10 hrs/day vs 1 hr/day pre-op. Occasional MRI-guided steroid injections by Dr. Jan Fritz at Johns Hopkins. Surgery video = http://www.youtube.com/watch?v=6FDwana6SQU

Deep neuropathic burning pain flares have been gone since surgery...Grateful to Dr Hibner.
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