nerve block essential for diagnosis

[Faith]

I am trying to figure out why a nerve block is essential for diagnosis of PN when so many people are getting 3T MRI's and MRN that say a pt is entrapped? It seems like almost everyone has horrible pain flares after having a nerve block so what's the point? I had an S1 nerve root injection with steroid and had a horrible flare. Unfortunately this will not diagnosis me for PN. I do not want another injection (with steroid). Do anyone know if there any doctors who will diagnose PN with either imaging only or a nerve block without steroids?

[Violet M]

Faith, I have heard of some of the docs giving just a marcaine injection without the steroid but I'm not sure which docs would agree to this -- you might have to contact them and ask. Dr. Antolak will give heparin instead of steroid if you prefer.

My understanding is the reason most docs do three steroid injections before surgery is because that is the "accepted" protocol for nerve entrapments -- not just pudendal nerve entrapments and the hope is that the steroid will reduce the inflammation enough so that you can avoid surgery. Surgery is even more invasive than nerve blocks so they try the least invasive options first. Until recently there hasn't been much knowledge of the 3T MRI being used for diagnosis of PNE and the MRN has not been considered to be completely accurate. So, nerve blocks are still used as one of the tools to assist in making the diagnosis.