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Pain in the butt - Can't sit down

Chronic Pain | Last Active: Sep 23 9:49am | Replies (336)

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@bkruppa

With as many doctors that we have been to ALL just want to prescribe meds to cover up the pain. When I ask or suggest possible causes like PNE, scar tissue entrapment, etc. they don't seem to know what I am talking about. As for surgery it appears that given that the pudendal nerve is so complex no doctor even wants to talk about this as a cure. I agree. In looking at photos of this nerve it is a multifunction nerve and while it goes to three specific places in the pelvic floor region there are offshoots that go all over the place so it is very complex. Surgery gone wrong could produce even more issues with the patient.

We have tried the massaging techniques in the above referenced books which helps some but nothing has been permanent. We've also gone to experts in this field and again while it has helped the pain eventually comes back. From what I've read it takes a very long time to permanently stretch a muscle so maybe we just haven't gone through these procedures long enough.

What is interesting is that there are times where my wife's pain is so low that she doesn't have to take any pain meds at all. Then the pain returns. We've tried to go back through the previous day/days to see what she did differently but can never come up with a reason for these low pain episodes. I would like to know if any of you have experienced the same variation of pain levels be it daily, weekly, monthly, etc.? I think this is a good clue for finding the source of the pain but we just haven't been able to tie it to anything she did or ate.

To those who have these issues the first thing I would recommend is to determine if the nerve is damaged or entrapped. If damaged research seems to say this is permanent and there is no known cure. I was told by a doctor at Mayo that if the pain intensity is constant all the time then the nerve is probably damaged. If the pain can vary either throughout the day or from day to day then the nerve probably is not damaged. In this case I would say the nerve is entrapped and then the above massaging techniques will be the path to follow for relief and/or cure. The other suspect area is at the pudendal nerve root which is at the spinal column. If there is inflammation at this point this could be the source of pain issues. One neuro doctor wanted to inject a steroid to reduce the inflammation. However, this would be an ongoing treatment and I would prefer to determine why there is inflammation there in the first place. This kind of treatment is somewhat common but as with any procedures on the spine it does have risks. We did not opt for this procedure.

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Replies to "With as many doctors that we have been to ALL just want to prescribe meds to..."

@bkruppa I mentioned this already. The single biggest thing that helped my pain and tension (I still have some sitting pain) was finding a therapist who does what is called "injury massage". He uses intense ultrasound while stretching you. He went up and down my legs, thighs and lower back. It took several 1 hour sessions and it's an expensive out of pocket deal. He thinks he's really "remodeling" the tissue. He also says if the pain varies and changes with time, it's not structural (i.e. not ligaments/bones, etc.). For me it's nerve compression from my myofascia/muscles (soft tissue) due to overuse/martial arts breakfalls ("scar tissue"), etc. He got rid of all the muscle knots in the lower legs. Regular massage won't change that - although as @jenniferhunter said myofascial release helped me (yes I had a John Barnes trained guy) but I had trigger points across whole regions - so the ultrasound really helped the most the quickest.

Some chiropractors have a high frequency vibrator called an RRT (rapid release). These might work well if the tension is close to the surface. Many have lasers and some have electrical stimulation, too (and you can do some TENS/EMS, too, yourself as you can buy those on Amazon). I am concerned chiropractors like to do their "adjustments". I don't particularly need or want the adjustment - especially since two discs are desiccated and bulging. I just like their other tools. Chiropractors often have the stuff.
Last, try an inversion table (talk to your Dr. about that - if the spine is too deteriorated or if high blood pressure it's not good). You don't spend a lot of time doing it - just a little - perhaps twice per day. That can take the pressure off the spinal nerve. I'm pretty sure that is what is causing my pain and tension (when I had it) - a pinched spinal nerve due to lower lumbar DDD. A pinched nerve can affect everything below it. pain, Sciatic pain, sitting pain, excessive sweating, affects the bowels (IBS like symptoms), etc. (they mention that in the headache in the pelvis book, too). However, more aggressive stretching and other exercises, too, that I detailed before are doing the trick for me. Keep trying different types of massage. You may not fully cure this but you might make it better. Stretches, vigorous walking, if tolerated, any other good exercises that are tolerated (I like TRX suspension training core exercises and lower body - TRX is the best for core strengthing I have found (no back aches since Christmas when I started TRX)) and extremely deep inspirations (lumbar nerve plexus runs through there and can not only cause pain but tension in the diaphragm) , try anti-inflammatory supplements (resveratrol + quercetin + rutin + turmeric in modest doses). It should help.

One more good book to read is "life after pain" by Dr. Jonathan Kuttner. He mentions chronic pain as well as meditation / mindful techniques. Also, maybe it won't help your wife - but try the deep breathing - really deep inspirations when you need it. Almost to the point of hyperventilating. That really helped me - but I had chains of trigger points and tension up and down my body and it wreaked havok. Often, when we are in pain, we tense up our muscles and don't breathe right. I'm trying to avoid drugs and injections for as long as possible. If massage works, try and find therapists / chiropractors with different tools and try them out. Some are reasonably priced and / or might be covered by insurance.