Health Organization for Pudendal Education

Hi April,

Thank you. I did read the info. The doctor did say the block would only last a couple of hours and she was correct on that one. She did not use any type of guide. It was done vaginally through the wall into the the sacrospinous ligament near the nerve. It was easy because we know that was the location of the problem. I had a hysterectomy and the surgeon sutured the pudendal nerve to the sacrospinous ligament. Three weeks after the hysterectomy the surgeon went back in and removed the sutures.

My thought process is, how can the steroid have added term relief if it doesn't stay at that specific location? If it's a liquid, will it not disperse? Does it somehow bind to the numbing agent? How can a steroid last last more the 24 hours? I really don't get it. So sorry, I love knowing the technicalities. Maybe I should just ask the doctor. If anyone is interested, I can post what she says.

You hit the nail on the head. A steroid injection would work inside the a joint because the joint is encapsulated by the synovial membrane, but the nerve is not. So how does it work?

The way I understand it from past reading is that steroids are anti-inflammatories that cause the inflamed tissues around the nerve to shrink which allows the nerve to glide freely. Theoretically if you don't have continued irritation, this could bring the inflammation down long-term, but if the nerve is entrapped and there is continued irritation, the steroid isn't going to give long-term relief. The steroid injections never worked for me at all and it turns out I had a nerve entrapment that was causing continued irritation of the nerve. Prof. Robert cautioned against more than 3 steroid nerve blocks because of possible nerve damage from the steroids.

I discussed PRFA in a newsletter at the following link. http://www.pudendalhope.info/sites/defa ... 202014.pdf
If you have a nerve block with a numbing agent such as marcaine that successfully takes your pain away for a couple of hours indicating that the nerve injected was the culprit, then you may want to try PRFA of that nerve for more long-term relief, although some people have said it initially causes a pain flare-up before providing any relief and they have to keep repeating the procedure.

Violet

Thank you Violet! That makes sense. At least I can understand how it works now.
My guess is, the steroid would work for me. The sacrospinous ligament is always stiff. I feel it pulling when I walk for a while. Here's to hoping.