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Pudendal Nerve Entrapment/Neuropathy/Damage

Chronic Pain | Last Active: Oct 29 9:41am | Replies (592)

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@bkruppa

Thanks for the last two posts. Let me take you back to how this all started and why I am looking into the areas that I am. My wife developed a bad case of shingles that affected the pudendal nerve. Her left buttocks and pelvic are had very intense pain that lasted for about four months. During this time she was pretty much bed ridden and favored laying/sitting on her right side. Once the shingles started to subside it appeared that in a few months the pain would be gone but unfortunately after about 3 months of the pain going down it stopped and I believe that something else kicked in. Myofacial issues due to being bed ridden for so long? Nerve entrapment given that all the areas supported by the pudendal nerve were still in pain? Sacrotuberous issues due to muscle inflammation? Spinal issues (at the root of the pudendal nerve) due to her favoring one side for so long? So there are many areas that I suspect could be the root of the problem.

Inflammatory meds like Advil help a lot so this would say the source maybe is inflammation or a strained muscle as Advil helps these conditions. My thoughts regarding an inversion table is that if the spine is cocked due to the favoring position then this would help get it back to normal. I've read much about blood pressure being a concern but question this as one's blood pressure goes up quite high when doing normal exercises and just about every doctor on earth recommends exercises and many set goals of working in your heart target ranges which is quite stressful (I don't believe in this approach). We both are senior citizens so we are at the age where muscle just don't move, stretch, reform, etc. like they did many years ago.:):) So she doesn't see instant results using any technique but she does get relief when being massaged in the painful areas. She has been to a PT who specialized in pelvic pain and while the treatments helped (mainly massaging) it wasn't lasting.

So three things seem prominent: First is that inflammation seems to be part of the problem. Second is that sitting causes the pain to get significantly worse. Third massaging helps but so far hasn't been a solution. Fourth, one neuro doctor has suggested that the source may be at the roots of the nerve which is at the spinal column. He indicated that an inversion table may help since favoring her one side may have caused one side of a disk to be compressed and therefore causing pain. Finally is the question of why some mornings her pain level is way down at a two or three level???? Other mornings it is not. That's what I'm working with. I'm thinking to take her to a normal PT clinic to work on straightening out her entire muscle system in that area. The PT specialist only worked on massaging the pelvic area.

As for your concern regarding full inversion my wife would never go to that extreme. Thirty degrees or around that angle would be the most and yes this would be after warming up the muscles. In fact she warms up her muscles before doing any stretching techniques.

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Replies to "Thanks for the last two posts. Let me take you back to how this all started..."

Thank you for all that. And as for the pelvic PT, that’s kinda crappy if they only massaged. A true pelvic floor specialist does far more specialized care. They have a certificatation for the pelvic floor (I do not, I specialize primarily in orthopedics, manual therapy and hope to learn Vestibular this year). They should have assessed mobility of spine, pelvis, hips, SIJ, etc. Hope seeing a new PT helps!!
As for the inflammation-until the problem is corrected it sounds like low level chronic inflammation that needs to go away!

@bkruppa You may want to look at myofascial release to free tight fascial tissue. I do this therapy myself for thoracic outlet syndrome which is a nerve/vessel entrapment under the collar bone area and it has helped me a lot. This is similar to massage , but the therapist holds the stretch and waits for the tissue to start to slide. According to the website, it helps Pundental nerve entrapment among many other conditions. MFR can also treat surgical scar tissue in the fascia. There are providers listed for Canada (your earlier post suggested this) at this link
https://www.mfrtherapists.com/app/list.asp?state=&country=CA
I created a discussion to collect information on MFR that you can check out at
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

An osteopathic doctor will be able to help your wife get her body form straight. That’s their area of expertise. They are sort of like PT and sort of like a chiropractor in one. I saw one for my pudendual nerve because I was favoring the side that didn’t hurt causing other problems.