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Pudendal Nerve Entrapment/Neuropathy/Damage

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

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@cake

I think I've had PN for 9 months now and at first laying down took the pain away, but now laying on my back I feel discomfort in my sacral area as well as buttocks. Has anyone wondered if the piriformis muscle might be involved in this? There is a surgeon, Dr. Tollestrup, who removes the piriformis muscle. I wonder if that would relieve pudendal neuralgia symptoms?

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Replies to "I think I've had PN for 9 months now and at first laying down took the..."

@shiak22 and others. I've posted many times in this thread and pain in the butt can't sit down thread.

Yes, I had some type of fibrosis and myofascial pain in the glutes and legs including piriformis issues and also tension up and down glutes and legs, sciatica, etc. I managed to get rid of it. I'll tell you how below. Please give it a try. Here is a book review I wrote for a book called "Why we hurt and how we heal" by Dr. Greg Fors (buy the white cover edition on Amazon). Proper stretching, nutrition and supplements helped me and most of my sitting pain is now gone. Bear in mind, if you compress a nerve inside tight muscles, it creates nerve pain. It's all in my review. For exercise, I use a TRX suspension system and all other manner of stretching (but also have a pilates machine (Aeropilates 700) and a Lifepro Rumblex 4D vibration plate and go to the gym for weights on machines and I stretch out daily. Good luck. Add the supplements, get moving in ways you can tolerate.

My review:
Dr. Fors book. Why we hurt and How we heal.

I've had some chronic myofascial pain in glutes and legs and I've found essentially the "cure" on my own. In the meanwhile I'd read other books such as "A headache in the pelvis". That book talks about the problem but doesn't specifically give you the cures (only some "cures"). However, Dr. Fors book is the go to book with practical tips and suggestions. His own story "case study" could practically have been my story with sitting pain and muscular tension. In his book Dr. Fors talks about oxidative stress on tissues, etc. For a person who's interested perhaps you could read it all. However, you can skip some and just go to the practical parts and use that information instead. I personally believe it is poorer circulation and poorer tissue remodeling as we age that causes these issues like myofascial tension and pain (including neuropathic pain). Apparently, I had some fibrosis / extra clotting going on as I got older (i.e. 58-ish). I believe the fibrosis in tissues / veins was causing poorer circulation and stiffness. While speculative, it may be deposits of fibrin (the blood clotting protein) that causes issues when deposited in veins, arteries and tissues and that tends to recruit cells of the immune system (granulocytes) and, hence, you also get "inflammation" (there is your low-grade autoimmunity tie in; these are my opinions; not something Dr. Fors mentioned). I believe this was true in my case. Supplements may alter and reduce this process. Read below for specific suggestions - many of which were mentioned in Dr. Fors book (I added 2 supplements to my regimen as a result of Dr. Fors' suggestions).

I do believe the supplements are the key to promote healing and proper tissue remodeling / regeneration which may go awry as we age and don't heal properly without the correct supplementation. Said differently, as you age you may need to supplement your diet with various plant substances and minerals, etc., for best health. His book is worth the price of that information alone which he details in a chapter on supplements / nutrition - but he doesn't mention adding a little hemp seed oil, etc. (I'm just writing this off the top of my head - there is a lot in this book - maybe he did mention healthy fats). As you take supplements, do check your blood pressure as these can vary it.

For me, proper supplementation (I added on a couple of Dr. Fors' suggestions, along with stretching and exercise) have largely "cured" my tension and pain in the lower back and glutes. I have lower lumbar degenerative disc disease (which is most likely a “perpetuating factor” for myofascial pain) but all my pain comes from muscular tension and pain - which can be controlled without NSAID's and without antidepressants for me (although for a time, I did use some nortryptline for nerve pain). Honestly, if you cure your gut health (Dr. Fors has a whole chapter on that) and take the right supplements, your myofascial tension and pain may go away on its own without needing to do a bunch of trigger point work (possibly; that is what happened to me - but he has a whole chapter on trigger point removal and has invented a tool you can buy separately for trigger point work - instead of using the usual balls and rollers for this). As one other reviewer said, until the root problem is cured the trigger points might simply come back - they did for me, too, at one time.

He has whole chapters about each topic. Especially, adding various supplements such as Flavinoids and flavolignins can really help you heal. Some of the supplements Dr. Fors mentioned such as ginger extract to calm digestion and Milk thistle extract (source of flavinoids) is one of many you can take (silymarin, the active ingredient in milk thistle extract, is a bunch of flavolignins, I believe; I also take diosmin / hesperidin and some quercetin (stay below 500 mg or so daily); these are all flavinoids, I believe / resveratrol; ORAC energy greens (full of plant stuff and - you guessed it flavinoids) and extra vitamin C (staying below 2000 mg daily) and a tblsp of hemp seed oil, and turmeric.

The regimen I use along with stretching and exercise reversed or is cutting down on my sitting pain / neuropathic pain in the legs and glutes (i.e. less "sciatica") and reduced fibrosis in the muscles/veins, etc. I also supplemented with enzymes nattokinase / serrapeptidase and lumbrokinase, too, taken between meals to help with possible fibrin (or other amyloid type deposits) in veins / tissues. These are counter-indicated if you have clotting disorders or about 10% of people simply don't tolerate these in the gut. These have never bothered me and helped tremendously. Unfortunately, Dr. Fors did not mention those supplements that might reduce depositions of proteins in veins / tissues and are thought to be anti-inflammatory. However, these might still be considered “alternative medicine” in the west despite being used in Asia for years. Regardless, you might cure your issues with the right supplements alone, without those enzymes. I found milk thistle extract, recommended by Dr. Fors, was a good addition to the above substances as a source of flavinoids. Yes, cut down on added sugars, too, as Dr. Fors (and everyone else in the universe talks about). I had tried some of the other supplements he mentioned (like devils claw - but found it increased my blood pressure). Many others actually lowered my blood pressure!

Thank you Dr. Fors for an excellent book. It was helpful and practical. I was not compensated for this review.

Wow I don’t l ow about removing thst muscle

I'm thinking of going to Dr. Tollestrup for this. Did you go to him? How was your outcome?