Hello. My name is Yishai. I am 28 years old, from Israel. I have been suffering from severe pain at the perineum area, mainly while sitting for almost 10 years now. I have come to a point where I can't function without Medical Cannabis 3 times a day. At first, I couldn't identify the pain's source, I have been to a lot of doctors, and finally, on last February I have done an MRI Neurography of the Pelvic Nerves. The MRI results showed a severe injury which starts from the left side of the pudendal nerve along the alckoks canal to the part of the nerve which connects to the perineum. The pain which I am suffering from is taking place exactly at the middle of the perineum. I was professionally riding a bike for something like 3 years before the pain started. The pain is getting worst while sitting, and there is no pain while walking. I have read and searched a lot, tried block injections, radio waves therapy and pelvic physical therapy. None of them worked for me. I would like to know more about other treatment options you might have for my condition. After that email, I will send an invitation with an option to watch the MRI scans. Also, I would like to send any medical information you might want to have and know about my contidion.
Thank you very much for your time and help.
pudendal nerve chronic pain
Re: pudendal nerve chronic pain
Hi Ishayxp,
Your symptoms, history, and MRI imaging certainly match what would be expected for a diagnosis of pudendal neuralgia. Many of the common treatment protocols for pudendal neuralgia are listed at the following link: https://www.pudendalhope.info/category/ ... t-options/ There may be some other options too but those are the typical ones. It sounds like you have already tried some of those options.
Did you have even a short period of relief after the nerve blocks? Like even for several hours? Nerve blocks often don't give people permanent relief but if you have even a short period of pain relief after a pudendal nerve block it can be diagnostic for pudendal neuralgia or potentially pudendal nerve entrapment. If the nerve is damaged from the injury, you should get at least partial temporary relief from a pudendal nerve block if it is given correctly. One way to tell if the nerve block was given correctly is whether or not you have temporary (several hours) of loss of sensation in the distribution area of the pudendal nerve, including the genitals and perineum. Treatment options would depend on whether you have pudendal neuralgia and whether the nerve is entrapped or not.
Did the physical therapist do an internal exam via the rectum? If so, did you have tenderness or pain along the course of the pudendal nerve? If you meet the Nantes criteria in the following article, you could potentially have an entrapment. https://www.pudendalhope.info/wp-conten ... iteria.pdf
What are your doctors recommending that you try next?
Violet
Your symptoms, history, and MRI imaging certainly match what would be expected for a diagnosis of pudendal neuralgia. Many of the common treatment protocols for pudendal neuralgia are listed at the following link: https://www.pudendalhope.info/category/ ... t-options/ There may be some other options too but those are the typical ones. It sounds like you have already tried some of those options.
Did you have even a short period of relief after the nerve blocks? Like even for several hours? Nerve blocks often don't give people permanent relief but if you have even a short period of pain relief after a pudendal nerve block it can be diagnostic for pudendal neuralgia or potentially pudendal nerve entrapment. If the nerve is damaged from the injury, you should get at least partial temporary relief from a pudendal nerve block if it is given correctly. One way to tell if the nerve block was given correctly is whether or not you have temporary (several hours) of loss of sensation in the distribution area of the pudendal nerve, including the genitals and perineum. Treatment options would depend on whether you have pudendal neuralgia and whether the nerve is entrapped or not.
Did the physical therapist do an internal exam via the rectum? If so, did you have tenderness or pain along the course of the pudendal nerve? If you meet the Nantes criteria in the following article, you could potentially have an entrapment. https://www.pudendalhope.info/wp-conten ... iteria.pdf
What are your doctors recommending that you try next?
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
Re: pudendal nerve chronic pain
Hello Yishai,
I am now 57 years old and I began having PNE symptoms in 2004.
I am not a doctor but I can give you some recommendation.
Again, this is not medical advice but just what has helped me.
I am taking a nerve pain medication callled Pregabalin.
I take 600mg at night.
Muscle relaxers help because they help the muscles relax that are intertwined with the pudendal nerves.
I ended up having Pudendal nerve decompression surgery in Nantes, France with Professor Robert.
It definitely helped but I had to still be very careful and keep a special cushion with me at all times to sit.
I can send you a photo of the cushion.
It will help you a lot since your pain is directly in the Perineum.
It will help suspend the nerves so that you are not actually sitting on them and just sitting on your sit bones.
Are you able to travel to the France?
The doctors that treat PNE or PN are very good.
I would also consider coming here to the USA.
We also have some very good doctors who have been dealing with these issues for 20 years.
I had a very hard time in 2004 because nobody knew what was wrong with me.
I went to 21 specialists all over the USA by train (first class laying down) because I couldn't sit to fly.
I don't know if you are male or female but being a man with this condition is very embarrassing and doctors tend to not want to treat men when it deals with the genitals.
If you would like some more information please don't hesitate to reach out to me.
Even if you just need someone to talk to I am here to support you
Take care and remember that surgery is the last option. (in my opinion)
I am now 57 years old and I began having PNE symptoms in 2004.
I am not a doctor but I can give you some recommendation.
Again, this is not medical advice but just what has helped me.
I am taking a nerve pain medication callled Pregabalin.
I take 600mg at night.
Muscle relaxers help because they help the muscles relax that are intertwined with the pudendal nerves.
I ended up having Pudendal nerve decompression surgery in Nantes, France with Professor Robert.
It definitely helped but I had to still be very careful and keep a special cushion with me at all times to sit.
I can send you a photo of the cushion.
It will help you a lot since your pain is directly in the Perineum.
It will help suspend the nerves so that you are not actually sitting on them and just sitting on your sit bones.
Are you able to travel to the France?
The doctors that treat PNE or PN are very good.
I would also consider coming here to the USA.
We also have some very good doctors who have been dealing with these issues for 20 years.
I had a very hard time in 2004 because nobody knew what was wrong with me.
I went to 21 specialists all over the USA by train (first class laying down) because I couldn't sit to fly.
I don't know if you are male or female but being a man with this condition is very embarrassing and doctors tend to not want to treat men when it deals with the genitals.
If you would like some more information please don't hesitate to reach out to me.
Even if you just need someone to talk to I am here to support you
Take care and remember that surgery is the last option. (in my opinion)