Health Organization for Pudendal Education

Hello everyone, I got my first CT guided nerve block today. I was fortunate to find a doc to do CT guided, and my pelvic floor therapist came along and observed. It made me feel more relaxed not knowing what to expect to have her there.
It really didn't hurt a bit, and oh I'm numb alright. I have been for at least 7-8 hours now, and I'm slowly thawing out (not sure I want to) I'm a little worried after reading about these 2 weeks flares people experience, but I guess it goes with the territory.
So I would assume I had a "positive" block experience - right afterwards I was not able to use my pelvic floor muscles, it's like they didn't exist. And slowly my perinium area became more and more numb, and my butt cheeks, inner thighs, and what felt like very deep rectaly was also numb. I guess he hit the right spot? So of course I couldn't feel my usual vaginal soreness, but my usual low abdominal burning and leg burning was still there. That would make sense, as that's a different issue.
Is this what I should be feeling? I mean I'm numb just like when I'm at the dentist, that kind of numb. Slowly this numb feeling is wearing off, it's been about 7-8 hours as I said.
The doctor couldn't really shed much light for me, as he is just an interventional radiologist, and I'm only his 3rd patient for blocks - not a big deal to him, but I was a little nervous. When I asked him about flares, and side effects, he said oh really I should feel just fine. He said if I feel a little better, and I want another injection he would do one in 4-5 weeks. That seems pretty normal from what I have read. He has never injected a patient in the alcock area, claims he has not needed to, so I'm a little freaked about that, but I can't worry about that now.
So to be clear, just because I'm numb in the perineal area, this is a "positive" block. If I felt nothing, no numbing sensation at all, then it would be negative, and not the pudendal nerve?

Thanks... Debbie

Hi Debbie,

Glad your block went well. If your "saddle" area is numb and you have significant pain relief it's generally considered diagnostic for pudendal neuralgia -- and it sounds like that's what happened to you. If there was a steroid included in the block it will "kick in" after about 4 days and you may either have a flare-up or additional pain relief, depending on how you respond to the steroid. It might help to use extra ice and pain medication if you need to then.

If you had numbness in the saddle area but no pain relief that is an indication that it may not be the pudendal nerve. If you don't get any numbness in that area then likely the block didn't hit the right spot. But it sounds like yours did.

Hope you will continue to get relief -- I would love to hear how it goes for you.

Take care,

Violet

Violet M wrote:Hi Debbie,

Glad your block went well. If your "saddle" area is numb and you have significant pain relief it's generally considered diagnostic for pudendal neuralgia -- and it sounds like that's what happened to you. If there was a steroid included in the block it will "kick in" after about 4 days and you may either have a flare-up or additional pain relief, depending on how you respond to the steroid. It might help to use extra ice and pain medication if you need to then.

If you had numbness in the saddle area but no pain relief that is an indication that it may not be the pudendal nerve. If you don't get any numbness in that area then likely the block didn't hit the right spot. But it sounds like yours did.

Hope you will continue to get relief -- I would love to hear how it goes for you.

Take care,

Violet

Violet-
Well.... it's been about 4 days, and I have noticed an increase in pain. Mostly more burning in my legs and burning in my lower abdomen and over the pubic bone area, just constant. I noticed an increase in low ab pain already after 2 days.... but now it's more intense. Actually my usual vaginal soreness is the same. Great, I guess no relief is in the cards for me. It they suggest a repeat block, I would have to say no if this is really a flare up.
I've been icing of course, and just took vicodin.
Just wanted to let you know.

Debbie

Debbie, it sounds similar to my experience. Sorry it didn't help and I can't blame you for not wanting to do another one. It would make sense to go for more if you are headed for surgery because many of the docs require 3 before surgery but if you don't see surgery in the cards then maybe you don't want to go through more blocks.

Hi Debbie
Keep going ! My last injection cause a flare that lasted for 3 weeks. I am now week 4-5 and it is slowly calming down. I know it's scary and frustrating at times not to know what should be happening, or what to expect. I was questioning going back for a 3rd block, but it's important to stick with it, because as Voilet says 3 blocks is the 'normal' before surgery is possible. Hope you start to feel better soon.
Hetty
x

Well I guess I don't know if surgery is in the cards for me, guess it's 50/50 - if this pain and interruption of life keeps up, I would explore if I'm a candidate. I hate how I feel.
It was interesting..... after the block, my low ab/pelvic pain increased, and my leg burning increased, but the vaginal soreness I would say stayed at the same level. In other words, I was numb for about 8-9 hours, and then the vag pain was there again.
I just spoke with my PT, she calls me at home to check up on me, I'm telling you this woman is an angel, any ways we are discussing this central sensitisaton thing now, and she is going to speak to my pain doc about it.
I'm not sure how I deal with that along with getting blocks, and maybe eventually being evaluated by Hibner, Houston, or Potter, but I almost think the leg and low ab burning is worse than the vag pain at times.
Now today is a better day, pain is more mild, but it could be raging by tonight... yikes who knows!

Hetty - thanks for your input, appreciate it. I surely hope your 2nd block helps you out of course, and I probably will be going for one more round - it's just so scary.

Hope you enjoy your weekend a bit,
Debbie