I was injured June 17, 2005: in a golf cart hit by a car. I had jammed my left leg tight to keep me in the cart and the sidewise hit by the car injured all the muscles in my left groin. I call it a groin whip lash. Didnt have any pain for 10 days and then whammo had the worst pain Ive ever had except childbirth. Hasnt stopped since: 24/7. I wasnt diagnosed until 2008 after seeing multiple docs: orthopods, neurosurgeon, etc etc. Also have had many many treatment options including physical therapy (which made it worse), spinal injections (which made it unbearable), acupuncture (which was awful), etc etc. Chiropractic adjustments, ultra sound and massage have been helpful.
I was again on the Internet hopefully trying to find some new info, etc after another neurologist had suggested my pain might be from the pudendal nerve. I certainly fit the symptom and history picture. I checked for providers and found Dr. Karen Noblett at University of California, Irvine who specializes in pudendal nerve, pelvic floor disorders. Since, luckily, I have a daughter who lives in Irvine, I went to California and stayed 3 weeks, in 2008. She confirmed the diagnosis of pelvic floor myathesia: in other words all the muscles/ligaments in my p
pelvic floor were in spasm, tight as drums, pushing on the pudendal nerve. I suspect that my nerve is caught between two ligaments but that is hard to discerne
My best relief–over time-has been after I have been able to stay in CA and receive a series of injections of small amounts of a steroid and a numbing agent; like 3 times a week. (The first few are unbearably painful but then that begins to ease)
Included in this is to learn to massage these muscles internally (intravaginally) with a glass probe, massage trigger points internally and externally, doing relaxing stretching exercises, etc. Her theory is that this treat,ment over time relaxes these muscles and reduces the over excitability of the pudendal nerve.
I finally did begin to get relief; never without pain but certainly reducing it from 10s to 4s. I finally found another provider closer to home in Overland Park, KS next to Kansas City who also does these injections. They are incredibly painful while the injection is happening, but it truly does begin to help.
I now have found a physician here where I live (Bentonville, AR) who now does a pudendal block: not doing each muscle but just blocking the nerve. It isnt as effective as working on each individual muscle in spasm. I can reduce the pain 5-6 points simply by doing the vaginal trigger point massage myself; I couldnt have made it this far without that ability.
I mistakenly decided to again do physical therapy to build up some core muscle ability; has taken me 3 weeks now to settle it all down.
There is a physician in Phoenix who is cutting the pudendal nerve but is having only limited success: maybe 20% reduction in pain after long painful recovery. This doctor also does trigger point and pudendal nerve injections. There is also a doc in Denver, CO. Id have to look him up.
My best source is a book entitled, “Headache In My Pelvis” by Drs. David Wise and Rodney Anderson. Order from National Center for Pelvic Pain Research, Occidental,CA 707-874-2225. This book is like my Bible.
I dont think most doctors, especially pain docs, know how to treat this. I now am convinced that all the other pain treatment , other than Dr. Noblett, just worsened the pain. Im convinced that Dr, Nobletts theory, as is Drs Wise and Anderson, that this trigger point treatment is the way to go.
Im like you; used to be an avid golfer, working, gardening, very very active and over time my world has become smaller and smaller. The worse thing is sitting: that is awful. I carry around a pillow always. Because I never know for sure when I;m going to have a flare I dont do much socially any more, though do play bridge once a week. But I never sit very long, I get up and walk around, or just stand behind my chair, etc.
I do not believe there is a cure for this malady; not yet anyway, but I do agree with the muscle relaxing, stretchiong exercises, trigger point massage, and cortisone injections of the trigger points in the pelvic floor are the most effective. And pain medication: I take a long acting morphine and shorter acting Dilaudid, Lyrica and Valium to sleep. I do spend a lot of time sleeping; more than I want but still must have the pain meds; but at least with the above treatment the meds cover the pain. I understand morphine is the med of choice for nerve pain.
Remember, the injection into this very tight trigger point in the pelvic floor is excrutiating and at first will cause a pain flare of a day to multiple days. But as the inflammation reduces the level of pain decreases.
I get terribly despondent and depressed at times but am just now beginning to accept that this is how it is: no cure. I have to live with this pain, but I do have control of the LEVEL of pain.
Guess thats enough for now. Id like to read your –and anyone elses thoughts.