Health Organization for Pudendal Education

Posted this elsewhere but I thought maybe it should have its own topic too.

TENS unit was very helpful post-op for relieving OI (obturator internus) muscle spasm. OI muscle spasms irritate the PN and cause burning pain.

PT told me where to put the electrodes. I had two channels on the TENS unit so I could do both sides at once.

One electrode goes just medial to the bony prominence on each side of the front of your abdomen. (also known as the anterior superior iliac spine. http://en.wikipedia.org/wiki/File:Gray435.png (medial meaning towards the center of your body -- so the electrode goes just inside that bone that sticks out in the front/side of your abdomen.

The other electrode in that same channel goes near your top inner thigh, close to where the body meets the leg.

Is that as clear as mud? The important thing is to do it for at least 2 hours a day. I turned it up to where I could feel it but it wasn't painful.

It was a bit of a trick keeping the electrode sites from itching after awhile. I used them over quite a few times because the used ones weren't as itchy. Sometimes used paper tape to keep them in place since it is hypoallergenic but what worked best was to wear thigh shapers to keep them in place.
http://www.spanx.com/product/index.jsp? ... age=family

Thigh shapers also worked well to keep gel ice packs in place, btw.

Violet

My PT tried TENS in the same spot (approximately), and some Dry needling of piriformis and glutes, its 3 days ago, but I am feeling rather worse....
On the other hand, classical PT (intrarectal trigger points release) makes no flare-ups anymore.
My PT that there is direct link between trigger points in rectus abdominalis and genital pain. Have you heard about it?

Flyer, I could not have tolerated the TENS unit before PNE release surgery. It was only effective for relaxing the OI muscle after surgery and that was at least nine months post-op after the nerve was starting to calm down.

Interesting about the rectus abdominus. I'd not heard that before. http://www.exrx.net/Muscles/RectusAbdominis.html I guess it seems plausible there could be a relationship since it controls the tilt of the pelvis.

Violet

Violet thanks for the info.
I will not resume Dry needling and TENS, I feel this might be dangerous if I am entrapped. Flare-up is not so vigorous as it was after ECSW (my biggest mistake), but the worsening is on my right side predominantely (this is my worse side). I had some dry needling to both piriformis, and I still feel how tender my piriformis and glutes are (a week after treatment).
On the other hand, I dont have flare-up after PT, which I once had. Will continue with PT, but no more experiments with needles.
I still think that dr. Aszmann might be right, that my only pathology is in right dorsal canal, this is the place where all my problems started 4 years ago. I remember that during first visit at urologist, there was no spasmatic muscles, no painful prostate, only neuropathic pain at the base of penis and I still got the feeling that the pain is arising from "somewhere behind", exactly where dorsal canal is. Left side was pretty unaffected. I think that all further pathology is secondary, spasmatic muscles, painful prostate etc, to repetitive injury to right dorsal canal. I tried to contact dr. ASzmann for PSSD test and maybe I will try the blocks into Alcock. Dorsal nerve decompression is pretty risky business with a lot of failures, but sometimes I feel that might save my life.

It's a really tough decision, Flyer. I hope you find something that works.

Violet

I saw the words "TENS unit" and though I would throw my hat in the ring and say that I i do not know what OI muscle spasms are... but I tried the TENS unit for a week or two on both sides of my bum for PGAD and it made thing quite worse . I heard this made other PGAD woman worse in the PGAD department too .

sadie wrote: i do not know what OI muscle spasms are... but I tried the TENS unit for a week or two on both sides of my bum for PGAD and it made thing quite worse . I heard this made other PGAD woman worse in the PGAD department too .

Obturator internus (OI) is one of the muscles that makes up the wall of the vagina. The pudendal nerve runs between this muscle and the levator ani muscle in the Alcock's canal. If you have pudendal neuralgia this muscle can be really tight and cause burning down your legs.

I agree about TENS units and PGAD. Before my surgery when PGAD was bad I could not use a TENS but it was really helpful after PNE surgery.

Violet

Hi guys,

Did the flare ups from the tens ever calm down?? I put 1 pad on each bum cheek and the pain has rocketed to 8/10, could any daage have been caused if the pads were near the injured nerve

thanks

Sorry to hear you are having a flare-up. I wouldn't recommend putting the pads right on or near the nerve. I expect it will calm down though. I tried a TENS unit before surgery and it caused flare-ups that eventually calmed down. Try some extra heat, ice, and pain meds for several days.

As I posted at the beginning of the thread, the TENS unit was helpful for me post-op. I think it was about a year post-op. It's probably best to check with your PT before trying it, to make sure you are putting the electrodes in the right place for you.

Violet