Left trapped / Right Pain
Posted: Tue Oct 29, 2013 1:35 am
Hi everyone,
I am posting here to gain further understanding of this condition which I have recently been diagnosed with. I am hoping other can assist me with my current situation.
I am a 37 y.o male in Sydney and have been suffering this for about 4 years, it has only been in the last 18 months that my symptoms were troublesome enough to effect normal day living.
Like others on this site my quest to find out what was wrong started approx 2 years ago when I was thinking I was having some sort of food intolerance with the excessive amount of toilet breaks at work. 6 months later a long return trip to Europe resulted in extreme nerve pain throughout my pelvis and could only manage sitting for 10mins without being buckled over in pain. My entire perineum area was red/inflamed and swollen and I had terrible sciatic pain in my left and right leg also.
However over the last 18 months through Endep, physio, stretching and changed working conditions my pain is minor (from an 8/10 to a 4/10) compared to 18 months ago, regardless there is still an underlying issue which is brought on by sitting if I was to do more of it. The majority of my pain initially was left sided but after a few months of physio/stretching Endep etc the pain seems to have switched to be predominately right side.
So about 2 months ago I ended up in Prof Vancaille office here in Sydney, went for a diagnostic nerve block (both sides) which worked for 48 hours as advised. My MRI report came back as
Left Pudendal Nerve : “Delayed separation of the sacrospinous and sacrotuberous ligaments. The adjacent pudendal nerve segment above the ischial spine cannot be clearly separated. Pudendal Nerve compression cannot be excluded”……..
Right Pudendal Nerve: Relatively Normal separation of the sacrospinous and sacrotuberous ligament. No significant narrowing of the adjacent perineural space…..
The follow up with Prof Vancaille in which he advised physio was not a great solution and that I consult an Orthopedic Surgeon regarding the Nerve entrapment. This week I met with the surgeon who suggested the TG approach with severing the sacrotuberous ligament.
So I am hoping people who are more versed in this condition can help with clarifying a few things before I book surgery or go back to Prof Vancaille for his thoughts.
- Why is it that my right side is extremely tight and sore down to the knee (understand the sciatic is also at play here) compared to my left which is relatively 100% normal. Surely an entrapped left pudendal nerve would affect the left more than the right side of the body? Or is this referred pain?
- Re the surgery, I was given the following ratio 33% excellent results, 33% good results, 33 no change but no worse than when they walked in from 70 or so surgeries. The surgeon did not seem to have answers re the above dilemma of left and right and suggested they could cut both… I don’t want to open a can of worms here, but surely this has long term effect of severing ligaments.
- Although physio was dismissed initially has anyone in Syd or Australia had good long term results from a physio/chiro/osteo for treatment of this condition? Since this was a gradual onset rather than a trauma to the area is it possible to work on the left side to try and realign the ligaments?
I have an appointment with my physio in a week and as a third party will discuss the severing of sacrotuberous from a biomechanical perspective.
Does anyone have any thoughts on the above?
Thanks
I am posting here to gain further understanding of this condition which I have recently been diagnosed with. I am hoping other can assist me with my current situation.
I am a 37 y.o male in Sydney and have been suffering this for about 4 years, it has only been in the last 18 months that my symptoms were troublesome enough to effect normal day living.
Like others on this site my quest to find out what was wrong started approx 2 years ago when I was thinking I was having some sort of food intolerance with the excessive amount of toilet breaks at work. 6 months later a long return trip to Europe resulted in extreme nerve pain throughout my pelvis and could only manage sitting for 10mins without being buckled over in pain. My entire perineum area was red/inflamed and swollen and I had terrible sciatic pain in my left and right leg also.
However over the last 18 months through Endep, physio, stretching and changed working conditions my pain is minor (from an 8/10 to a 4/10) compared to 18 months ago, regardless there is still an underlying issue which is brought on by sitting if I was to do more of it. The majority of my pain initially was left sided but after a few months of physio/stretching Endep etc the pain seems to have switched to be predominately right side.
So about 2 months ago I ended up in Prof Vancaille office here in Sydney, went for a diagnostic nerve block (both sides) which worked for 48 hours as advised. My MRI report came back as
Left Pudendal Nerve : “Delayed separation of the sacrospinous and sacrotuberous ligaments. The adjacent pudendal nerve segment above the ischial spine cannot be clearly separated. Pudendal Nerve compression cannot be excluded”……..
Right Pudendal Nerve: Relatively Normal separation of the sacrospinous and sacrotuberous ligament. No significant narrowing of the adjacent perineural space…..
The follow up with Prof Vancaille in which he advised physio was not a great solution and that I consult an Orthopedic Surgeon regarding the Nerve entrapment. This week I met with the surgeon who suggested the TG approach with severing the sacrotuberous ligament.
So I am hoping people who are more versed in this condition can help with clarifying a few things before I book surgery or go back to Prof Vancaille for his thoughts.
- Why is it that my right side is extremely tight and sore down to the knee (understand the sciatic is also at play here) compared to my left which is relatively 100% normal. Surely an entrapped left pudendal nerve would affect the left more than the right side of the body? Or is this referred pain?
- Re the surgery, I was given the following ratio 33% excellent results, 33% good results, 33 no change but no worse than when they walked in from 70 or so surgeries. The surgeon did not seem to have answers re the above dilemma of left and right and suggested they could cut both… I don’t want to open a can of worms here, but surely this has long term effect of severing ligaments.
- Although physio was dismissed initially has anyone in Syd or Australia had good long term results from a physio/chiro/osteo for treatment of this condition? Since this was a gradual onset rather than a trauma to the area is it possible to work on the left side to try and realign the ligaments?
I have an appointment with my physio in a week and as a third party will discuss the severing of sacrotuberous from a biomechanical perspective.
Does anyone have any thoughts on the above?
Thanks