Health Organization for Pudendal Education

Hello,

Well as I am in between finding a surgeon to potentially have labral tear surgery, my pain doc wants to do a block to the PFCN to rule this out as a cause for my pain, before I plan any hip surgery. The reason she is looking at the PFCN, is because that is the only area that showed scar tissue on my Potter MRI. My Potter MRI showed 'Scarring lateral to the ischial tuberosity between the ischial tuberosity and the sciatic nerve, in the area of the course of the PFCN'..I also have a labral tear on the left side as well.

My thoughts are that YES, it may be the PFCN, but if the PFCN is irritated because of compensation due to the hip, than blocking it isn't going to prove the PFCN is the pain source.

So do I do the block first? or do the labral tear first?

My symptoms are lower left labia pain which is tender to palpation, soreness about 1 inch inside vestibule left side, tenderness left side perineum, back along pubic ramus to just inside sits bone. Cannot sit at all, lest I pay for it for days....If I have to sit, I am usually in some type of pretzel position so as not to put an pressure on my 'problem areas'. I know this is not ideal, however, I do what I have to do to get by.

Oh and one other question, she said she would block the PFCN where it exits the sacrum. I have not seen this anywhere as an injection location. If she blocks it here, will it reach all the branches specifically the PBPFCN?

Thanks in advance,

Diane

My own personal rule of thumb is to perform the least invasive procedures first and work my way up to the most invasive which is surgery. Her recommendations of the PFCN block is the least invasive and for me that is where I would start. The higher up the nerve you block you stop the transmission from any lower branches. Do you have any pain down the back of your leg as that is a pretty typical complaint of patients with PFCN? You might want to ask her how she will not block any of the other nerves that come out of the sacrum if that is where she plans to block. Good luck and keep us posted.