Pudendal Nerve Blocks

[PNist]

Hello everyone, I just got diagnosed with PN after I had MR Neurography. I had vestibulectomy 3 months ago and am still miserable and in pain. My MRN report shows that I have thicker and intense left pudendal nerve than the right one. Since I have no clear cause (no fall, surgery, trauma) my doctor advised me to have the steroids first. What determines the success rate of steroids? I'm on Lyrica but it doesn't help at all. 

[pauline19]

I had the MRI (or CT? so long ago) where they ran in 1mg of steroid with the contrast as a diagnostic thing. 

If you get ANY relief from the anti-inflammatory effect of the steroid, then the doc will know that yes, the pain is in that specific spot. I got relief that lasted about 8-10 days as I recall. But the pain came back and so I had the nerve block. 

The MD who did the nerve block DID hit the exact spot--but it caused loss of bowel and bladder control--Cauda Equina, they called it, which translates as "saddle numbness"!! That was two years ago. Oddly enough, the worst of the pain has been gradually decreasing though anyway.....

[Cardinal]

Senaozsu - so are you saying the pain is FROM having the vestibulectomy done?  Or you already had the pain and had the vestibulectomy done in order to reduce the pain?  I've heard nothing good about people who have had the blocks with the steroids - only increased pain. Also, if they are saying your nerve is entrapped, then the name of the condition you have is PNE, not PN, which is important, as the treatment is completely different between the two.

[PNist in reply to Cardinal]

Hello,

Yes I had the pain before having the vestibulectomy done. And no, nobody said anything about having either PN or PNE. My MRN report writes that I have thicker and more intense left pudendal nerve. I had no traumas, no falls, no nothing. The pain started while making out with my boyfriend, and wouldn't go away. But the amount of pain is incredible. I live in Turkey and nobody does vaginal pudendal surgery, so I'm left with only steroids. 

[Cardinal in reply to PNist]

I would make a huge bet that your pudendal nerve pain is from overly tight pelvic floor muscle. From how it started. You likely have a pelvic muscle that is impinging on the pudendal nerve. I doubt it is entrapped. So it would be PN. Are there any physiotherapists in Turkey that specialize in women's health? A good one would be able to find the tight muscle (internally) and release the muscle. If there is no therapist that you can see, you can try to release the muscles on your own. Most people use the Therawand that you can buy on the internet. Use it to find a tender area of muscle and once you find a tender/painful muscle, you press on it with the therawand for about 30 seconds. 

Here is a good article about PN:

pudendalnerve.com.au/2013/0...

[PNist]

Thank you for you responses, you've been very helpful! I guess I'll learn about the therapist when I go to see this new doctor who'll give me injections. Can stress cause tight muscles? Also, I read somewhere that if PN is the cause of vestibulitis, then it might come back. I'm incredibly scared of that. I hope that won't happen to me..

[Hidden in reply to PNist]

What dose of Lyrica are you on? I take full adult dose 600mg. I've had to increase really slow but it only helped at full dose. Most people find relief at 300mg. Maybe you could try increasing. They also say adding Cymbalta helps which I also take at 60mg.

[PNist]

I've been taking 300 mg but it doesn't help at all, so since yesterday I started taking 450mg, and see how it goes. I guess only the pain specialist I'll see on the 20th can prescribe Cymbalta, so I'm waiting for that but I'm on Laroxyl (amitriptyline). Lyrica doesn't really help me.

Do you think only stress can cause this much pain? 

[seraphina]

Surgery instigates.a lot of nerve problems, I have levator ani.4 days after surgery to remove an ovary.