Health Organization for Pudendal Education

OK, I have had 6 pelvic floot PT appointments, the last one being a dry needling of several muscles. I feel worse after every one of these sessions. Now I am sore from all these needles and feel worse in the pelvis. Should I continue this PT? Seems everything I do make it worse. It hurts when she presses on these trigger points inside my rectum and they keep trying to stretch and now inject this little muscle...the obtutator or something like that. I am not getting better from it. Should I go on for weeks more in hopes maybe she can find something to help. I kept worrying she was going to hit the nerve with those dry needles. Dr Dellon told me the nerve is probably damaged since it came on after trauma(surgery) and therefore needs to be 'cut out' !

Frigator,

Physical therapy definitely does not help everyone. I had years of pelvic PT with very good therapists and I always flared after the appointment and never made progress. However, six is not very many appointments, maybe try a few more and see if you are still in the same place. As far as Dr. Dellon, I do not have personal experience with him, so I cannot advise you on what he told you. I think getting several opinions from medical professionals and reading about others’ experiences can be valuable.

Stephanies

I went back today and this lady is really working to try to help me. She dry needled two more muscles again, the piriformis and the obturator internus which evidently could press on the nerve. She got out a nice atatomy chart showing the muscles and nerves and really is the only person who has spent any time down there where it hurts. So maybe I will forge forward and take your advice Stephanies. There are so few treatments available maybe I need to give this PT lady more time to work. I still dont understand this electrode deal on the anus muscle where I am to pull in, then realax it and make the muscles bulge to lengthen them.

I dont see her again till next Wed so will have time to rest up. I just wonder if its worth the sit time in the car to go there. I feel better the less I sit. If I can go a whole week without leaving the house and no sitting at all,, no driving....then I feel better. So far the best treatment I have found is not to sit. And going to the PT means 15min there, 15min back sit time.

Do you think you feel better after a week in the house because you do not sit at home? Could there be another reason? You are different from me in that my pain is constant, I wake up during the night in pain.

Stephanies

Yes, if I stay home and dont sit my pain does not flare up. I cant think of any other factor... I have bought a standing desk and one of those hospital tables that go up and down to eat on. So I stand most of day, try to get my daughter or wife to run my errands, bring home food. And try to lay down in afternoon as my knees and other hip hurts from all the standing. I have lost 17lbs from all this standing. But unfortunately not standing does not get rid of the pain, just prevents the aggravation of existing pain. And I cant imagine having to life like this the rest of my life.

And its when I leave the house that things get worse from the sitting. I have pain all day too that gets worse as the day goes on, but thankfully not much pain in the night. Unless I go to PT which flares me too.

Sorry to hear of your constant pain Stephanies. And having pain in the night.
Are you considering any other treatments?

Myofascial release of the pelvic floor muscles used to give me a flare-up before I had PNE release surgery. I quit doing it because I thought it was just irritating the nerve more. I can't say what is right for you but that was my experience. When your PT presses on the nerves via the rectum, which nerves are tender? If your pudendal nerve is painful when she presses on it via the rectum (at the ischial spine or Alcock's canal), that could be an indication that you have a nerve entrapment of that nerve, especially when you also have some of the other Nantes Criteria for pudendal nerve entrapment -- including pain with sitting.

Violet