Possible PN?
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frustrated0814
- Posts: 3
- Joined: Mon Dec 29, 2014 6:36 pm
Re: Possible PN?
Hi Frustrated,
Welcome to the forum. Some of your issues are similar to what mine were, including the history of weightlifting but the difference is that it sounds like you are getting better with some lifestyle changes and that's good news. Hopefully by being careful you will be able to heal.
Often with chronic pelvic pain there is more going on than just pudendal neuralgia. I had SI joint dysfunction, hamstring, piriformis, gracillis, obturator internus, levator ani muscle issues, as well as pudendal neuralgia. My severe pain, that originally started as an ache, was primarily on one side which is suggestive of a nerve entrapment. Over time the pain moved into other areas including, the piriformis, gluteal area, low back, and feet. But you can have pudendal neuralgia without having a nerve entrapment. If your muscles are in spasm and tense from over-training they can be pressing on the nerve and irritating it. In my case the ligaments were hardened and sclerosed and impinging on the nerve causing irritation but hopefully for you the muscles are just tense and if you can get them healed and relaxed you will be OK.
If your pain is manageable and you are getting better with lifestyle changes, I think a lot of people on this forum would suggest avoiding any invasive treatments like pudendal nerve blocks because sometimes people get worse from them. An SI joint block or ischial tuberosity block are a bit different than a nerve block though. It's pretty hard to miss the target when injecting at a bone if they are using image guidance, although the steroid can wander a bit so my guess is there would still be a slight risk involved. A nerve is different from a bone though. It's harder to locate and may be more susceptible to damage from the steroid or being nicked by the needle.
Good luck. I hope you will continue to see improvements with the conservative treatments you are trying.
Violet
Welcome to the forum. Some of your issues are similar to what mine were, including the history of weightlifting but the difference is that it sounds like you are getting better with some lifestyle changes and that's good news. Hopefully by being careful you will be able to heal.
Often with chronic pelvic pain there is more going on than just pudendal neuralgia. I had SI joint dysfunction, hamstring, piriformis, gracillis, obturator internus, levator ani muscle issues, as well as pudendal neuralgia. My severe pain, that originally started as an ache, was primarily on one side which is suggestive of a nerve entrapment. Over time the pain moved into other areas including, the piriformis, gluteal area, low back, and feet. But you can have pudendal neuralgia without having a nerve entrapment. If your muscles are in spasm and tense from over-training they can be pressing on the nerve and irritating it. In my case the ligaments were hardened and sclerosed and impinging on the nerve causing irritation but hopefully for you the muscles are just tense and if you can get them healed and relaxed you will be OK.
If your pain is manageable and you are getting better with lifestyle changes, I think a lot of people on this forum would suggest avoiding any invasive treatments like pudendal nerve blocks because sometimes people get worse from them. An SI joint block or ischial tuberosity block are a bit different than a nerve block though. It's pretty hard to miss the target when injecting at a bone if they are using image guidance, although the steroid can wander a bit so my guess is there would still be a slight risk involved. A nerve is different from a bone though. It's harder to locate and may be more susceptible to damage from the steroid or being nicked by the needle.
Good luck. I hope you will continue to see improvements with the conservative treatments you are trying.
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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tooyoungforthis
- Posts: 5
- Joined: Wed Dec 03, 2014 7:17 am
Re: Possible PN?
Frustrated, we're in this together! I posted about a month ago, you can read my story here: http://www.pudendalhope.info/forum/view ... f=2&t=6349
I have nearly the same exact issues that you have. At the time I was doing weighted lunges, squats, deadlifts as well as prolonged sitting on a hard surface. In my case it started with a dull testicle ache. Within a month I notice I had really tight hip flexors and adductor insertion point soreness. This has never fully healed in 1.5 years. I still have the testicle pain as well when under constriction or sitting.
Your tuberosity pain while sitting sounds exactly the same as mine. This warm/cold sensation near the tuberosity/back of hamstring/inner groin that sometimes runs down the leg into the foot and is relieved upon standing. I haven't done anything with the piriformis or pudendal nerve yet. I have an appt at the pain clinic next week to see what they can do. I sort of lived with this for a year hoping it would relieve itself but it never did and doctors were never proactive about anything. PM me if you want and we can discuss treatments etc. If you have any luck please post some more and lets conquer this mystery!
I have nearly the same exact issues that you have. At the time I was doing weighted lunges, squats, deadlifts as well as prolonged sitting on a hard surface. In my case it started with a dull testicle ache. Within a month I notice I had really tight hip flexors and adductor insertion point soreness. This has never fully healed in 1.5 years. I still have the testicle pain as well when under constriction or sitting.
Your tuberosity pain while sitting sounds exactly the same as mine. This warm/cold sensation near the tuberosity/back of hamstring/inner groin that sometimes runs down the leg into the foot and is relieved upon standing. I haven't done anything with the piriformis or pudendal nerve yet. I have an appt at the pain clinic next week to see what they can do. I sort of lived with this for a year hoping it would relieve itself but it never did and doctors were never proactive about anything. PM me if you want and we can discuss treatments etc. If you have any luck please post some more and lets conquer this mystery!
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frustrated0814
- Posts: 3
- Joined: Mon Dec 29, 2014 6:36 pm
Re: Possible PN?
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Last edited by frustrated0814 on Mon Jan 12, 2015 1:58 pm, edited 1 time in total.
Re: Possible PN?
Can't say for sure what would be right for you but here are several possibilities.
Since you have pelvic alignment issues you might want to try seeing a manual therapist, possibly one who uses the Hesch method to see if you can get your alignment straightened out. (See Jerry Hesch's contact info in the PT list from the homepage at pudendalhope.org. He is in Nevada but has trained others around the country) I had several prolotherapy injections into the SI joint that were helpful in stabilizing my pelvis. They are painful for about a week but are meant to help the ligaments heal. If your ligaments are strained you might want to try some prolotherapy.
For the muscle spasms you could try a benzodiazepine such as valium or clonazepam to relax the muscles. Some people have had effective relieve from muscle spasm from Botox injections but there are some people who are sensitive to it and reported worsening of symptoms so there is a small risk involved with Botox injections. If you try it, be sure to go to someone who is experienced and can work in conjunction with your PT to figure out which muscles are in spasm. Dr. Gajraj, whose article is in our publications list recommends injecting the muscle with an anesthetic (I think Marcaine) to see if it works before injecting Botox.
Konedog had good results from electroshock wave therapy but that involves traveling to Canada so I don't know if that would even be an option for you. Some people have had success just from lifestyle changes or from mindbody therapy but those didn't work for me.
Take care,
Violet
Since you have pelvic alignment issues you might want to try seeing a manual therapist, possibly one who uses the Hesch method to see if you can get your alignment straightened out. (See Jerry Hesch's contact info in the PT list from the homepage at pudendalhope.org. He is in Nevada but has trained others around the country) I had several prolotherapy injections into the SI joint that were helpful in stabilizing my pelvis. They are painful for about a week but are meant to help the ligaments heal. If your ligaments are strained you might want to try some prolotherapy.
For the muscle spasms you could try a benzodiazepine such as valium or clonazepam to relax the muscles. Some people have had effective relieve from muscle spasm from Botox injections but there are some people who are sensitive to it and reported worsening of symptoms so there is a small risk involved with Botox injections. If you try it, be sure to go to someone who is experienced and can work in conjunction with your PT to figure out which muscles are in spasm. Dr. Gajraj, whose article is in our publications list recommends injecting the muscle with an anesthetic (I think Marcaine) to see if it works before injecting Botox.
Konedog had good results from electroshock wave therapy but that involves traveling to Canada so I don't know if that would even be an option for you. Some people have had success just from lifestyle changes or from mindbody therapy but those didn't work for me.
Take care,
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
Re: Possible PN?
Someone sent me a PM that Jerry Hesch has retired, unfortunately. But you may be able to find a good manual therapist for your alignment issues.
Violet
Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
Re: Possible PN?
If people have testicle pain check if your inguinal ligament is compressed or you may have an occult hernia also. Just a suggestion.
Pudendal pain started in Feb 2014. Potter MRI- useless findings (dont waste your money), tried pelvic floor pt, ART, Trigenics, Osteopathic treatment, fascial work, Massage, Shockwave, world renown chiros, osteopaths and PTs, stretching bla bla. Nothing helped but shockwave (which was short lived) and one world renown chiro that is a douchebag because he cant treat me again. All in all, God is the only one who can lead your path.