Pudendal Nerve Entrapment/Neuropathy/Damage

Posted by mandiPNE @mandee, Oct 5, 2018

Hello from a new member. Am wondering if anyone suffers from the monster Pudendal Nerve Entrapment/Neuropathy/Damage? I do. And I'm very alone in it. It is a very uncommon condition, and because of its personal nature, one that many people may not be comfortable opening up about. There seems to be a more vocal/visible presence of patients in the US, AUS and France. I hope, I need, I want - for it be made more aware of here in Canada. If there is any one who suffers from it, or who thinks they might, please feel free to open up about it. Please join me in advocating for ourselves in this horrible condition.

Interested in more discussions like this? Go to the Chronic Pain Support Group.

@donfeld

I've had many back operations including injections and nerve blocks. Surgeries cause an incurable disease called arachnoiditis which is caused by spinal leak from the bad surgery here at the Mayo Clinic. Haven't slept for years all night ain't gone too many doctors to try and figure out what's going on with my pelvic area. Finally got you a great pain doctor says look at you want to sleep at night? I am taking oxycodone 5 mg at night and I sleep like a baby now. I've given in cuz there is no cure and there's no fix. Opioids aren't bad you just got to know how to take him and get the right kind of doctor to give it to you. Just be careful don't overdo it control it exercise like you're doing but stop the injections and nerve blocks. Just stop the pain. 5mg Oxycodone is not going to hurt you once or twice a day.

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@donfeld
Since you have arachnoiditis I strongly urge you to do some reading at http://www.arachnoiditishope.com and http://www.intractablepain.com There is a self help protocol that WILL help with your pain and overall health. You will also find a bunch of into. for you to print out and take to your doctor. Best wishes to you!

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@jesfactsmon

@qball2019

Thanks for the link to the article about PEA (Palmitoylethanolamide). I will look at it.

My wife Linda, who has severe PN burning in her feet, started taking PEA a few weeks ago. So far she tells me that she thinks it is giving her energy. I'm not sure about what it is doing for her pain, but it seems like (and I know this is too early to come to any conclusions whatsoever) she is in less pain overall. Just my impression, not her statement, although she and I have not discussed it in depth yet. She did stop it for 2-3 days because she thought it was making her tinnitus worse. But I think she is back on it again. She takes four 400 mg pills per day. In case anyone wants to try it, here is the link to the kind she is currently taking:
https://smile.amazon.com/gp/product/B01HFN5R9I/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1
Best, Hank

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@jesfactsmon

So glad to hear that your wife is already taking PEA! Not sure what she is taking for inflammation but she may want to start Tumeric and maybe take some info. in to her doctor. There is some very interesting reading about pain and inflammation on both websites I listed. Please urge your wife to check them out. Best wishes to both of you!!

Here is the PEA (Palmitoylethanolamide) that I'm taking. I take one in the morning and one at night. https://www.amazon.com/gp/product/B084T9BFHT/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1

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@qball2019

@jesfactsmon

So glad to hear that your wife is already taking PEA! Not sure what she is taking for inflammation but she may want to start Tumeric and maybe take some info. in to her doctor. There is some very interesting reading about pain and inflammation on both websites I listed. Please urge your wife to check them out. Best wishes to both of you!!

Here is the PEA (Palmitoylethanolamide) that I'm taking. I take one in the morning and one at night. https://www.amazon.com/gp/product/B084T9BFHT/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1

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@qball2019 Thanks. I clarified with my wife what she meant by feeling more energy and she said she is feeling less pain and that is what is giving her the energy. She is taking 4 400 mg caps/day (or was; I'm not sure, she is doing a lot of experimenting with it). Her brand is Nootropics Depot. What Turmeric are you taking? Best, Hank

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@angellagalante

Hi Helen. It is but you can get relief it takes time.

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Yes, am learning this from others. Find the best solution & stick with it. I MAY b getting the 5 day TRIAL for the spinal cord nerve stimulator. It will help my very complicated spine pain & my Pudendal nerve Neuralgia type symptoms!!
My Pudendendal nerve BLOCK under CT scan did NOT helped me, which proved that I do not have exactly this...but ALL similar symptoms in the pelvic floor !!
Mary Ellen

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@qball2019

@donfeld
Since you have arachnoiditis I strongly urge you to do some reading at http://www.arachnoiditishope.com and http://www.intractablepain.com There is a self help protocol that WILL help with your pain and overall health. You will also find a bunch of into. for you to print out and take to your doctor. Best wishes to you!

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FYI intractablepain.com no longer exists and the domain is for sale

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@vklittle61

Yes I’ve had it for two years now

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I am a wee bit late with this reply. Has anyone been able to help you? I have been doing better diet wise and that has almost eliminated my problem.

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@bkruppa

My wife has had pudendal nerve pain for 8 years. Initially the pain was due to a bout of shingles. However, during the recovery period I believe that something new kicked in which I believe is PNE (Pudendal Nerve Entrapment) as the symptoms are identical and to me it makes sense. The pain areas in the pelvic region are exactly where the pudendal nerve goes. PNE normally is resolved by relief of any muscle or scar tissue that may be entrapping the pudendal nerve. There are many facilities around the country that treat this condition and the treatment is massaging, dialators, etc. of the muscles that could be entrapping the pudendal nerve. My wife gets some relief from this kind of treatment but it is temporary and it only helps some. We have been to many facilities including the Mayo Clinic but the doctors don't seem to recognize PNE as mostly they want to use pain meds as a course of action. We want a solution. We have tried nerve blocks in the caudal area as well as lower in the buttocks with zero pain relief.

There is a muscle group that entraps the pudendal nerve and that is the sacrotubernous ligament which can easily entrap the nerve. There are specific massaging techniques that can relieve this pressure.

Given that my wife's pain varies doctors have agreed that the nerve is not damaged. This is good news as apparently there is no treatment for a damaged nerve.

We have looked into neurostimulators. My main concern is affect on other nerves in the probe area as well as other more serious issues. I contacted two companies about their devices and neither company has any data on helping pudendal nerve issues so we would be on our own as far as what to expect. However, I had heard about paralysis as a possible side affect. Again I contacted both companies regarding the frequency of this issue but neither would respond to my requests. That was unfortunate. Then we find that a neighbor down the street from us was paralyzed due to this procedure. Now I don't want to scare people out of going through this procedure as this is a case of one out of ...............I don't know. A 100. A 1000, A 10,000. I just don't know. A doctor at Mayo told us that 20% of these need to be readjusted (surgery) within 5 years and over time they become less and less effective. Given all of the above we chose not to go through with the procedure.

Another neuro doctor is suggesting that the pain is due to inflammation of root of the pudendal nerve which resides at the spinal cord where it connects to the spinal column. Here they want to inject steroids to reduce the inflammation. Results may be nothing, good for two weeks, two months,????? They can't predict. IF this is the source then my choice would be to determine why it is inflamed at this area and resolve this issue rather than throwing meds at it.

We are also looking into inversion tables as a source of relief. The theory being that maybe her spine is shrinking due to aging and therefore entrapping the pudendal nerve. Also since she favors sitting on one side to relieve the sensitive side maybe the spine got reformed and therefore entrapping the nerve. So we will give it a try to see what happens. We have also tried acupuncture, all the suggested vitamins for neuropathy, etc., but with no success. I read a lot of articles where sugar can cause nerve pain issues to heighten so we will be doing a sugar free diet for a couple of weeks to see what happens. MRIs show nothing but a dual frequency laser treatment has helped some but for only a day or two. My wife is on gabapentin and CBD oil. CBD oil takes some of the edge off of the pain so she uses it frequently.

Scar tissue may be another cause of entrapment. Women who have an an episiotomy during child birth can develop scar tissue in this area which is close to where the pudendal nerve travels. Haven't found any doctors who buy into this theory but a lot of my wife's pain emanates from this area so I am suspect. A PT friend of mine says that when a rotator cuff is torn in the shoulder scar tissue can form around a nerve and cause pain. In these cases surgery has helped release the entrapment. However, the nerves in this area are not complex nerves like the pudendal nerve which I guess is one reason most doctors don't want to do anything invasive since they may end up causing damage to the nerve which would result in even more pain.

Sorry for the long post. However, I wanted to present everything that we have done. I would like to hear from the rest of you about what you tried and what were the results.

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I have an extensive episiotomy scar (50 years ago) and now suffer w/ nerve entrapment. Considering CBD oil and wonder if she is taking it internally or using it topically? Working w/my chiropractor/naturopath but progress is very slow and pain constant. I have increased my calcium supplements to take the edge off the pain, a little help but not enough.

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I see your post is 2 years old, and wonder if you have found any relief? I am interested in knowing whether anyone has had any success w/CBD oil, either internally or topically. Or any other non-steroidal topical treatment?

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@gardenvariety25

I see your post is 2 years old, and wonder if you have found any relief? I am interested in knowing whether anyone has had any success w/CBD oil, either internally or topically. Or any other non-steroidal topical treatment?

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Hi there @gardenvariety25
The person you are addressing, @mandiPNE , who started this discussion never posted again. Its likely they are no longer following Mayo Connect (although I have been surprised in a situation like this before so you never know). But one thing about this forum is that there are sure to be some people who are in a similar boat as you and who might have experimented with cbd oil or have other ideas that might help you.

If you use the search function above (click on the magnifying glass symbol) and type in cbd you will find a lot of discussions in which cbd oil is discussed, not for your specific problem in most cases, but for a variety of different conditions. At least you can get a sense of how people use it and what its track record is like. And you can address any of the individuals in the discussions and ask them your questions. You'll likely get some feedback, some hopefully useful to you.

Also, there are other discussions about pudendal issues, again you can find them by putting "pudendal" into the search window. I do hope you find answers you are seeking. I also hope (and believe) that you will connect with others who are familiar with, and sympathetic to, your pudendal related problem. The wonderful thing about Mayo Connect is the people on here. Very welcoming and understanding as well as warm and compassionate. It's a support group as much as it is a place to exchange info, although i is great as that as well.

All my best to you, Hank

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@1mepnurse

After 8 weeks of all these monster symptoms, I had a Nerve Bock of the Pudendal Nerve, under CT scan guidance. Cortisone & lots of numbing meds were injected.
I got NO improvement, SO....it is ruled that I do NOT have PNN.
In researching & with my Dr & chiropractors help, tomorrow I go to an highly recommended Pelvic Floor Therapy! I spoke with one of them. It's MORE THAN LIKELY something triggering these pelvic floor symptoms.
Some of their therapy is uncomfortable, but she says I should start getting some relief with these treatments. I am VERY hopeful!!

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@1mepnurse and others. I had some kind of nerve compression as well as lower lumbar DDD. A lot of the symptoms seem like a neuropathy - but they could be myofascial pain, too. In the pelvis, you have sheets of muscle that can become tense. Depending on your age and physical condition, you can try any or all of what I suggest, below. My sitting pain is much better and there is not much leg tension and shooting pain including sciatica any more for me. I'd posted this previously for someone else who had suspected pelvic floor dysfunction (sorry, long post):

I might recommend something unconventional. I have lower lumbar DDD and that makes for pain sensitivity to those area you're talking about. I think you should really try the enzymes nattokinase, serrapeptidase and lumbrokinase. You'll want to add them slowly and also keep doing exercises that keep you moving and strengthen the pelvic floor (I personally love TRX suspension work and Pilates reformer). You can heal and the tissue can remodel. You can also boost your consumption of flavinoids in general + extra vitamin C spaced out to assist with healing. I believe the enzymes will be the miracle workers including getting rid of bumps / cysts / etc.. I'm going to post a review I wrote for a book by Dr. Greg Fors re: "why we hurt and how we heal", 2nd edition. In that review, I've summarized everything that I do along with a review of the book. Beware: the enzymes might be counterindicated if you are on blood thinning medications (warfarin, etc.). Also, about 10% of people are irritated by these (gastrointestinal irritation). Otherwise, you should be OK. There are affordable versions of nattokinase and Serrapeptidase out there. Here goes with the review and protocol.

Dr. Fors book. Why we hurt. How we heal. Sorry, this is a long post:
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, which included some pelvic floor tension, I believe. 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!

Short version: supplements can help relieve inflammation and nerve irritation and stretching and exercise - the right ones - can also really help. Good luck, hope some of this helps. Rich

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