Health Organization for Pudendal Education

Hello All,

Lately, I have severe pain coming from the superficial transverse perineal muscle. Even gentle palpitations on parts of this muscle band are unbearably painful. I am only seeing my physcial therapist once a month due right now due to her schedule. Has anyone else had this problem? Does this muscle cause anal pain and spasms as well as pain in the perineum? Is anyone familiar with a way to help this muscle relax?

Thank you,
Stephanies

I can't speak from personal experience but just brainstorming some things that might possibly help such as ice or heat (or alternating), valium vaginal suppositories or B&O suppositories, sitz baths, or myofascial release/massage. Do you have a TENS unit you could try?

Violet

Hi Stephanie
Are you still having this pain? This sounds exactly what i was having the last few months and I may be able to help you. My pain was pretty bad rectal muscle spasms and also perineal pain. Dr Hibner and Loretta both said it was a muscle spasm. So I had a perineal nerve block. Now I am working with my pelvic floor physio who is emailing Loretta for her expert assistance since she examined me prior to my nerve block (Dr Hibner's PT). My PT specifically does very gently massages on the leviator ani muscle internally from the perineum to very slightly irritate it. Then she works on massaging the muscles (not sure which ones sorry) on my bum very close to my incision line near the lower spine area. This has helped so much! I have even taught my husband how to do the massaging on my bum and I can do the perineum massaging myself now. It is very easy. After the physio session, Loretta said to ICE the perineum to prevent a flare. Like Violet suggested, I also use the Valium/ Baclofen vag suppositories that Dr Hibner loves so much (twice a day).

I hope this helps you? It has really saved me from excruciating sitting pain.

Take care

Lara

Thank you Violet and Lara,

I think I always have some spasm and tension in this muscle but sometimes it get lumpy and painful enough that it seems to tear the skin around the anus and perineum and urinating becomes excrusiating if it touches the area. I have the suppositories from Dr. Hibner. I had stopped using them a few weeks ago because I get sleepy from them, but I will start again, at least at night. I have been feeling very stressed lately over this pain, espeically when I tried to wean off my tricyclic and ended up in agony. I have been off Prozac for about 10 days because I sometimes have a fluttering feeling in the clitoris and I am terrified of developing PGAD from the SSRI. I have increased my tricyclic to try to compensate for this mood-wise. MY PT refuses to acknowledge that I have anything more going on than a muscle issue when I am 100% sure there is nerve involvement as well. When she works on the OI, I get a very bad flare which could be a sign of nerve entrapment. Thank you for the suggestions, I will ask my PT for things I can do at home as well. I am just worn down and feeling very depressed and stressed right now. I appreciate all your help.

Sincerely,
Stephanies

Hi Steph,

Sorry this is wearing you down so much. You know, when I really thought I was going insane I used to insert a frozen ice balloon vaginally and push it up against the nerve on the side. It does help numb things up and helps you get to sleep when nothing else helps. Definitely a temporary solution but every little thing helps.

I had PGAD when I had never ever taken an antidepressant in my life -- so it's not always related to SSRI's. They are powerful drugs affecting the nervous system so when you wean off you have to do it slowly. When I went off lexapro, which I took to dampen the PGAD symptoms, I took an entire year to wean off by cutting back by 1/8 pill per week. That's how terrified I was of PGAD returning. So I understand your fear.

Violet

Has anyone else had this problem? Does this muscle cause anal pain and spasms as well as pain in the perineum? Is anyone familiar with a way to help this muscle relax?




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