Health Organization for Pudendal Education

Hi everyone I've just joined this forum looking for some advice and possibly answers. I'm 23 and managed to trap a nerve last week whilst I was at work, I'm a support assistant so do quite a bit of manual handling.
The symptoms began with my buttocks groin and thighs going numb like when a limb feels its going to sleep. I thought it might be circulation problems as I am currently taking beta blockers for migraines. A week later I am still completely numb it worries me especially in the groin area as I had sex with my boyfriend and was unable to feel much.

I have some lower back tightness and pain. My hamstrings are also very tight. The numbness seems to encompass the whole area from my lower back and stomach to my knees though I've noticed the tops of my arms are also pretty numb too. I went to see my GP he prescribed naproxen and said its an inflammation and once that goes down the nerves will sort themselves out. I don't trust doctors and know that this will probably not resolve so easily. I' m paying to see a physiotherapist so I can get their advice on what I should be doing. Reading up on the net I find that the longer you leave it the worse things become so I'd like to tackle it early.

I'm just really scared at the moment, I don't want to be unable to feel half of my body

please any help or advice

Something is wrong biomechanically for sure. There is a reasonable possibility that your GP is correct; if it is a soft tissue injury (that is, an injury of a muscle or other non-skeletal body component), then naproxen, a heating pad or ice (whichever feels good), rest and time should sort it out. It is not true that things get worse over time with an acute soft tissue injury, they do in fact frequently get better and go away.
The problems become chronic, and worsen, in those of us that have untreated or improperly treated joint injury. For that your GP would not be much use, you would want to see a PT Manual Therapist, Chiropractor, Osteopath, or anyone else who has experience with hands-on discernment and correction of joints. Not all practitioners who do joint work have the same level of expertise, but if you have a joint injury at all it might be a simple one to correct. It can't hurt to seek some joint assessment sooner rather than later, if it will put your mind at ease.
Please remember the reason you are seeing all the narratives of people who got these symptoms and then just kept getting worse and worse, is because you are reading the stories of chronic pain patients who are so entrenched in long term disability that we habitually discuss it on internet chat forums. You are not going to see stories on the internet written by people who got hurt, took it easy for a couple of weeks, and got better. Why would they bother putting such a story on the internet? Your GP probably sees lots of people who got hurt and then got better, which is why he treated it as no big deal. I am not trying to make light of the situation, which sounds like it would be scary, I am saying do start with the simplest solutions first and I hope your injury fully resolves, many times the body does heal itself.

Hi Miffy,

I don't want to alarm you, but the symptoms you are describing are somewhat suspicious for MS. I say that as I suffer from MS and have experienced the same symptoms that you are experiencing currently. Hopefully your symptoms are due to something much more benign, but I do think that you should request a referral to a neurologist even if your symptoms go away. Don't ignore this even if you feel better. Many neurologists believe that treating MS early can make a big difference in the progression of the disease. Again, I don't want to make you even more worried than you are, but anytime people experience what is called "saddle anesthesia" ie numbness in the area that would make contact with the saddle and horse if you were riding, then that is considered a neurologic emergency and also indicates that you should be seen by a neurologist.

Please keep us posted.

Lo

Miffy, obviously none of us can diagnose you over the internet, especially since we are not docs, but if you are still experiencing loss of sensation I think it's important for you to get to the ER immediately to have cauda equina syndrome ruled out. The sooner the better so as to prevent possible permanent damage. Check out this link for more info. http://www.emedicinehealth.com/cauda_eq ... ge2_em.htm

It's possible you just have some inflammation and rest, naproxen, and heat will be all that's needed but with the loss of sensation you are describing I would not take the chance to wait around and see.

Sorry you have nerve issues.
I would keep looking for a doc that can acutally help you.
you are doing the right thing by not trusting the first doc without a second and third oppinion.

My nerves were crushed between 2 ligaments and that is what caused my numbness from the waist down, but I had no issues above the waist.
Only my pudendal and obturator nerves were entrapped.

Have you considered neuropothy?

Sorry I'm not a doc and can't cure you. Just wanted you to know numbness happens and there is always a reason for it so keep looking.

Good luck

Thank you everyone for your replies, I haven't been able to update until now as I have been in hospital for almost two weeks following these symptoms. I went to a physiotherapist to get another opinion she wrote a letter out for me and told me to go to A&E immediately as she suspected cauda equina.
I was seen by a GP who said he didnt think it was that he felt it was MS gave me some steroids and then sent me home. The following day I felt more numb and was struggling to walk so I went back to the hospital who then kept me in. I've had 3 MRI's of the brain and spine without contrast. These all came back clear. Various blood tests which were all fine apart from them finding my blood sugars are unstable. Initially they were really high which they felt was due to the steroids which they had me stop. I'd only had them for two days and after that my blood sugars were really low and dropping mainly during the night. They think I have hypoglycaemia but other than that I have been discharged with no answers.
The numbness has improved but it's not fully come back. I keep getting pain down my legs and behind my kness also in the groin area. It seems to come and go. My legs still feel weak and seem wobbly when standing. I also keep getting a burning sensation on my feet which seems to happen at night.
I'm apparently going to get an outpatient appointment with a neurologist and a clinic which deals with blood sugars. In the meantime I have no clue in what I have.
Gusselsprouts I'd be interested to know about your experiences. I feel I should have had an MRI with contrast or I could just be being paranoid. A lumbar puncture has been mentioned as has a nerve conducter and visual evoked potential but I feel like they've just given up on me as my MRI was fine.

I'd appreciate any advice as to where I go from here as I'm still off work and wondering what went wrong

Goodness, you've been through the mill!

I am so glad that things have improved a bit, even if it is just a little. It is good that you are seeing a neurologist, if he feels you should have a contrast MRI then no doubt he will order one. The lumbar puncture will give a definitive answer as to whether or not this is MS.

I am sure they haven't given up on you. Remember that A&E are all about emergency medicine, you did absolutely the right thing going there - as Violet said, it did sound like cauda equina. But once you are improving on the ward then sending home is absolutely par for the course, they don't keep people in if not necessary. Tests had all been done, you were stable and improving, hence the decision. Beds are in short supply and people heal better at home. Outpatient appointments are where the long term stuff gets sorted out, and I hope that you don't have long to wait.

In the meantime, take care of yourself. If things get worse again, then go straight back to A&E.

Hi Miffy,

I'm so relieved to hear from you! Now have an explanation for your "disappearance"! Sorry to hear that you were in the hospital, but it was probably for the best. Sounds like they got a good start on sorting things out, actually.

I agree with Calluna, things will get further sorted out when you see your neurologist. Yes, for MS, normally they do an MRI with and without contrast. However, if you had already been on IV steroids it probably would have been a waste of time to do it with contrast at that point as the steroids would have "calmed down" any lesions that normally would have lit up with contrast. So it's my guess that that is why they didn't do it with contrast as well. I think your neurologist will probably order an MRI with contrast when you see him or her. A lumbar puncture, evoked potentials are other tests that can help with a diagnosis of MS.

Sometimes an MRI of the cervical spine as well as the thoracic and lumbar spine is also ordered because lesions can also occur in those parts of the spinal cord as well as the brain. But sometime people can have a diagnosis of MS with all the tests being negative--i.e., no lesions show up on MRI, negative lumbar puncture results, etc. It really is a clinical diagnosis.

If you do have MS, this episode that you are having now will get better, so please try not to despair. I know how frightening it is. Try not to get overheated. Most people with MS have heat intolerance. Don't take hot showers or baths as it will just make the weakness in your legs worse.

There will be lots of support for you from local MS groups to a UK MS Society, I'm sure. I'm in the US, so I'm not really up on the UK MS groups, but doesn't J.K. Rollins provide a lot of support to the UK MS Society?

And perhaps you do not have MS! Is Lyme Disease a concern in Great Britain? It is a disease carried by ticks and can mimic many of the symptoms of MS.

Please let us know how things are going for you. I'll be thinking of you.

Lois, aka "Gusselsprouts"

I am glad to be out of hospital the one I was in doesn't have a neurology department the only neurologist I saw had travelled from a different hospital and was obviously very rushed. His initial opinion was that the symptoms were caused by an injury but I had an MRI of brain as well as spine which showed nothing. I eagerly await the outpatient appointment with him. It's nice to be able to have a good nights sleep at home, I was being woken throughout the night to test my blood sugars and forced jam sandwiches at 3am when they had dropped. I think the blood sugars have settled since which makes me wonder whether it was the steroids that sent them out of wack.

To be honest I've felt unwell for two years now. First it was tinnitus and hyperacusis, then my eye sight became really grainy and flashy and I suffered with vertigo on both occasions. Just recently my migraines worsened considerably to the point I was getting them daily and the symptoms I got with them changed to me being almost paralysed on one side during the aura stage. I can't help but think these were warning signs surely somebody doesn't get all these symptoms from no where... I feel like a hypochondriac.

The numbness is beginning to dissipate thankfully, I am still finding it hard to walk much and I have cramping/aching in my groin area and down my legs. This seems to come and go but can't see much of a link to what worsens it.
It's interesting you mention getting overheated. On a few occasions (usually when I'm tired) I seem to get an allergic reaction from having a bath where my skin suffers from prickly heat and I get a tightness round my chest. This only happens now and again and always when I'm tired.. as its only occured after me doing a long shift at work.

I've been looking into lyme and although its not a big problem in the UK its apparently on the rise. I am going to mention it to my GP but I think if I had that I've probably had it for some time and it doesn't seem too easy to diagnose or treat at this stage.

Thank you both Calluna and Lois for your kind words, I'm stuck in limbo at the moment it seems but I will keep you updated, something tells me I still have a long way to go until I find what is wrong

Interesting about the migraines, I went through a phase when I used to get them - sometimes I used to get both the headache and the sight disturbances, sometimes just one or the other. I am wondering, do you think that your sight disturbances could have been a migraine without the headache?

Also interesting about the reaction to heat, my mum who has had MS for 60 years has the exact opposite, she is much better when she is warm and loves hot weather, it invariably sends her into remission if there is a hot sunny spell when she is having an attack. Funny how it goes, isn't it.

By the way, I certainly don't think that you are a hypochondriac, that doesn't seem to be your attitude at all. Please don't go there! You've had a lot to deal with and it is high time that someone had a good look at it all, the neurologist is undoubtedly the right person for that. So in the meantime, take things quietly - and enjoy not having jam sandwiches forced upon you in the middle of the night!