Looking for input on next steps. I’ve had pain for app 6 years but the last 3 have been worse. I have been working with a gynecological specialist who is president of the International Pain Society and she has run out of tools for me. I’ve also seen two pain management doctors and pain psychologist.
Diagnostic pudendal nerve blocks provided no relief. Vulvodynia and pelvic floor are involved but the worst pain is in lower buttocks. I can’t sit for long and driving is almost intolerable. Mornings are fine but symptoms build as the day moves on and I’ve sat some. The pain feels like someone is taking a fist to my lower buttocks and squeezing, pinching, and then poking with with sharp nails.
I’ve tried pelvic PT three times. Pelvic MRI was fine, Botox injection, PFCN block, ischial tuberosity ultrasound and block, bilateral transformational steroid/nerve root block. Hip injections. pelvic stretches (no kegles) pain meds, hormonal creams (I am post menopause) various cushions, acupuncture, TENS unit, a 4 week self-directed mind body program using Dr Howard Schubiner’s workbook, meditation, and I’m sure I’m leaving out some.
I’m working with a gastro to alleviate bad constipation and will see a neurologist and urologist in January. It takes months to get most appointments.
I walk on a track 2 to 3 miles daily, use dumbbells, and do light, leg/butt strengthening exercises, none of which hurt. I am thin and have no other health issues.
I’m thinking at this point my pain is not nerve related. I’m seeking a regular PT who accepts my insurance to possibly work on the piriformis and psoas muscle, maybe with deep tissue massage.
I’m decently coping but curtailing social activities and travel gets me very sad. I sit some nights with feet bent using ice packs. Each step in a new direction feels futile and its difficult to be hopeful.
Any thoughts? Thanks.
My first thought from your description was piriformis spasms. They can be quite painful. For me it was from hypertonic muscles (too tight). The PT can help you try to relax them. It depends on what caused this in the first place. I'm sorry for your suffering. These can be hard to treat.
Thank you. I can't figure out precisely what caused it but I think the constipation and straining has contributed. Also I lost a little bit of weight and I'm kinda small to begin with so working on the glutes is something I'm trying. Since pelvic PT hasn't worked I have nothing to lose by trying regular PT.