Health Organization for Pudendal Education

Hi all, I'm back again... After 2 nerve blocks and pulsed radiofrequency neuromodulation things for me are worse than ever I'm afraid. This time last year my primary symptoms were erectile dysfunction after cycling and sometimes after I did a long run or rower, cross trainer at the gym. Wind things forward a year and after 2 nerve blocks and pulsed radiofrequency modulation it seems to be more or less permanent if I even walk a moderate distance. I don't notice it immediately, it's usually a day or so after a long walk and it doesn't recover quickly... It's quite upsetting seeing as before the injections things weren't that bad and erectile function had been quite good until July this year. It feels like the doctors have made things worse! The "pain psychologist" I have been seeing says that this is not possible - nerve blocks and PRFNM can cause flare ups but not permanent changes.... Any thoughts?

Anyway, I am wondering about physical therapy... No one I have been seeing seems keen on the idea. I have been seeing Dr Baranowski in London and he has more or less said that there is nothing else he can do for me. He talked about more, deeper injections but so far these injections just appear to have made things worse. Dr B and my physio say that internal physical therapy is not common in the UK and it's better to try to learn your own relaxation techniques. What are your experiences with physical therapy? Does it help? Dr B also said that it can trigger flare ups which is worrying. I also read a lot about "wands" and self massage, has anyone had any success with those? I have Amy Stein's book Heal Pelvic Pain and it describes how to give yourself an internal massage... I tried that but couldn't find any tight points or painful bits - not sure if I was doing it right though but whatever I was doing didn't help. Someone else here has suggested ultrasound to relax muscles - is this worth trying? If so I wouldn't even know where to go to get it!

I'd appreciate your thoughts

Bertie posted the names of some good UK PT's in this thread:

http://www.pudendalhope.info/forum/view ... f=2&t=6255

Unfortunately, there are some people who attribute a worsening of symptoms to nerve blocks. The ones I heard of happened very soon after the blocks -- not gradually over time.

I'm sorry to hear of your worsening in symptoms and hope you will be able to find some therapies that help.

Take care,

Violet

I totally agree with you that Nerve Blocks can cause a more or less permanent worsening of symptoms. Our situations sound very similar - I too have had two nerve blocks - with the 2nd block 3 months ago. I have been dealing with the "fall-out" of symptoms from that ever since. Before the 2nd block, I was slowly getting to a point with running where I was feeling good with short distances - (up to 3 miles), with no after effects. Now, even after walking a mile or two, I can feel the after effects which can last up to several days or week or more. Partial ED is also an unwelcome symptom. It is all very frustrating, depressing and disappointing to say the least. Walking and running have been my mainstays of exercise and relaxation for many years, and it is really depressing not to be able to do it.

I had been doing PT since the beginning of mid-October, and I too was doing the Amy Stein exercises at home. (I also have the crystal wand, and I do believe the internal massage does help sometimes). However, the exercises started making me feel worse, so I stopped PT altogether, and actually started feeling much better - to the point where I actually felt like walking again. However, I am not even close to the point with being able to walk a few miles without suffering from after effects.

I am going to be trying out a different PT next week - one that is much more experienced with PN and has had training from from the Pelvic Health and Rehabilitiation Center (PHRC) that is located in CA. Perhaps this PT will have more insights into a particular treatment to get me to a point where I was prior to the 2nd nerve block. I have come to the conclusion that all of this is trial and error. I really regret having had the 2nd block. In hindsight, I was seeking perfection, where I should have just settled for good enough, and let things alone.

I will post back on the new PT - hope you are doing better.

Physical therapy is the practice of restoring function and movement that is impaired due to injury, illness, pain, etc. Therefore, PT seeks to reduce the effect of these things (ie, reduce pain, increase flexibility, etc).

Speaking of low back pain, specifically, there are a variety of treatment approaches available, each with their respective amounts of scientific literature to back them up. At the top of the list is specific exercise and manual therapy. It is the process of evaluation that is important in understanding what types of treatments will be appropriate for you. Treatments still exist, however, that are poorly supported by scientific literature including massage, electrical stimulation and ultrasound. These are, unfortunately, still used in both PT and chiropractic care...but those clinicians who are on top of the current research tend not to use them.