Pudendal nerve block question?? - Pelvic Pain Suppo...

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Pudendal nerve block question??

Dem74 profile image
15 Replies

Hello all,

I am going for Botox for my high tone pelvic floor disorder....which means a condition in my virgina and rectum that has intense tightness, stabbing, burning and gripping pain around the clock. The question I have is my doctor asked if I wanted the pudendal nerve block when he gives me my Botox injections. He would inject the pudendal nerve with a mixture of like lidocaine. My pudendal nerve is not entrapped just irritated . Should I get the block? He said it’s up to me . Are there benefits to it . Is it safe? Not sure what to do...thank you in advance

Warm regards

Danielle

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Dem74 profile image
Dem74
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15 Replies
kalecolbe12 profile image
kalecolbe12

Hi I have/had the same exact thing but mostly in rectal area....I can't even imagine having it in both...it is a living hell!!....so have had it since January...been doing pelvic floor physical therapy once a week to help relax the muscles and relax the spasms..she also has me doing breathing exercises and stretches which I didn't understand why it would help but believe me it does....it takes months to reverse the spasm ..I also went on cyclobenzaprine muscle relaxer which has been a godsend....so here I am almost 6 months later a lot better but still working on it.i can have Botox as long as I have tried pt and other stuff first and if they don't work fully my insurance will pay for the botox...if I was you I would get the block with the Botox because sometimes Botox works well and for some it doesn't work very well plus you may have to have it done again a couple of times from what I have read of people's experiences.... Please let me know if Botox works for you ...my email is mbhs21@gmail.com ..email or pm me any time...it's good to have other people to talk to who are going through this,thanks,Audrey

kalecolbe12 profile image
kalecolbe12

I forgot to ask...have you tried pelvic floor pt?sometimes it's good after our get the botox so that when the Botox wears off you have already worked on the muscles to relax them

Mohammed1985 profile image
Mohammed1985

Yes I would say get it and if it is the pudendal nerve then you should feel much less pain there is an amazing website with everything regarding pudendal nerve pain

It's amazing seriously has all the infor all the symptoms all the ways of diagnoses also all the specialists in the world who treat this problem

Also they have an amazing forum where people with pn talk about what they have had etc and what worked best and a lot of people after the block felt a lot of pain went away for 3 months to 6 months at a time please check this website out

Www.pudendalhope.info

Skye22 profile image
Skye22 in reply to Mohammed1985

Hi there, I read in a previous post where you recommended website. What a find!!! It has the most comprehensive info I have read to date, it can be a bit technical in places but I have learned sooo much about pn and more interestingly is how a lot of our conditions are similar and misdiagnosed. I have levator-ani syndrome amongst other things ,but after reading this article im not so sure. I see my specialist in a couple of weeks for a botox review and I will definitely be asking if this is a right diagnoses. I see a specialist physiotherapist for vaginal trigger point therapy, it is painful however I get at least a week of reduced spasms which for me is amazing I get to sit on my bottom like A normal person, just need to extend it to the other 3wks but it's early days!!! Thank you so much for recommending website. Good luck to you all with your treatments.

Moomoosmum profile image
Moomoosmum

Hello Danielle,

It's awful living with this i would imagine. i had a Ganglion Impar block on Tuesday, which is often used to treat Pudendal nerve issues. Prior to Tuesday, they thought I had this too, but the MRI showed a cyst at the base of my spine, which is irritating the ganglion of neves that come from the base of your spine.

Have you had an MRI to diagnose what you have? what other treatments have you had to date?

Godsgurl profile image
Godsgurl in reply to Moomoosmum

Moom, how did the ganglion impar help you? Sounds like you have Tarlov cysts like a number of us have. I have a huge one at S2. I have severe rectal and perianal pain/pressure. Two top neurosurgeon advise me treating my cysts with surgery but it is a very risky procedure with no guarantees.

MultiT profile image
MultiT

I had the nerve block and am glad I did.

Julieamb profile image
Julieamb

I have had botox and the nerve block and they have both helped.

BustedBiscuitsTX profile image
BustedBiscuitsTX

Nerve root PN blocks are a way of life for me. Here is my opinion. If you are just going to have lidocaine then, NO. Have you ever had stitches? A mole removed? If so, they likely injected the area with a form of lidocaine to numb the area first. As you know or suspect, it wears off relatively quickly. Lidocaine injections into the pudendal nerve are generally diagnostic as you get instant relief that will last max 24 hours. That isn't going to calm an irritated nerve. What calms the nerve is the steroid component when they do a lido/steroid mix. This type of injection will give you the immediate relief from the lidocaine and then about 5-7 days later the steroid portion kicks in. Each persons window of relief can vary but I hear many get up to 6 months. I prefer to get the deep root procedure done. However, when things are burning and numb I will take the regular injection at Dr Martin's office. I'm not picky! hahaa. I know these are less likely to help your pn but I also use those valium/baclofen/something else suppositories. Martin says when things are really bad that you can place one rectal and one vaginal. The urogyno who handles pelvic floor confirmed that this was correct. It has calmed some of the worst spasms and burning/pins needles from the pn. It's just a temp fix. But man, I sure will take it on those bad days! I know this was long and it's okay if you tl;dr. Good luck!

Dem74 profile image
Dem74 in reply to BustedBiscuitsTX

Hi- Thank you so much for responding. I think I will have to reconsider the PN block for my procedure this coming Tuesday. Wishing you all the best! Thank you so much again- Take care.

BustedBiscuitsTX profile image
BustedBiscuitsTX in reply to Dem74

Wait!!!!! Please discuss this with your doctor first. I'd hate for you to miss out on even a little bit of relief. I have a very complex case and see one of the doctors people travel across the world to see. So please, ask your doctor what kind of relief you can expect to receive from the injection. How long will it last? Is it just numbing or a combo of numbing and steroid? Is it costly? I mean, even if it's just lidocaine you really have nothing to lose by having injected, right??? I agree that pudendalhope.info is a good place to visit. I believe they also have a facebook page too. I want to cheerlead you on. I sometimes just give honest commentary without thinking that maybe even that little break of pain might be all someone else needs to kickstart their rehab. Consider it or at least call them today with those questions so you will know for tomorrow. Good luck!! <3

Yacoub profile image
Yacoub

I have had the block, not trapped either. Will be doing a second one and then Botox. With my experience I would say your Dr is right on with his treatments! Best of luck. I would do it if I were you!!

Fourweddings profile image
Fourweddings

Hi Danielle, I have been diagnosed with pudendal neuralgia and have had cranial osteopathy, women’s health internal physio and acupuncture and my symptoms have improved dramatically. Worth trying all of those. Good luck.

Dem74 profile image
Dem74 in reply to Fourweddings

Hi thank you so much for responding to me. I have had the block now and may try some of your suggestions in addition. Thank you again. Best of luck to you.

Moomoosmum profile image
Moomoosmum

I'm glad you've had it done Dem, has it begun to work yet?

I had a pain spike straight away and am still at that point. Its 2 weeks tomorrow since I had the block (with steroid). Long story, but had to see dr last Tuesday as he hadn't explained what might happen.

So after the pain spike you plateau out for 2-3 weeks before it starts to come back down. I'm still at plateau stage.

My nerves are very inflamed due to the length of time elapsed before it was diagnosed (19months).

Mine isnt PN.

The biggest thing for me is the physical movement of the ganglion of nerves. It's so hard and fast that it moves me from side to side. That for me is the worst part of this.

Has botox helped anyone else? I might asked for that if this doesn't calm gown.

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