wondering about pelvic nerves in addition to pudental

[LauraBee]

I have extreme pain sitting, and can only sit a couple hours total a day on a partially inflated donut cushion. Last week I had a pudental nerve block, and also had a long-acting steroid and amniotic allograft injected into the area. The first 24-hours after the block, I felt relief in the genitals, perineum, and rectal area: warmth rather than cold, and the bothersome tingling stopped. The doctor advised me to sit without a cushion that first 24-hours to see if the block worked in the targeted area. While I felt relief in the "middle", I still felt sharp and dull pain on the sitz bones, which radiated in towards the vagina after a few minutes of sitting. I'm wondering if there are other nerves that could be contributing to the pain.

Muddying the waters is the fact that a year and a half ago, I had an MRI, which showed partial tears at the hamstring origin and ischial bursitis. A cortisone injection at the bursa helped for two weeks. I also had platlet-rich plasma injections in the hamstring tendons. However, I don't think I can assume its bursitis causing the symptom, because when the doctor palpated the bursa, the location of the bursa seems to be more to the "outside" (lateral) of the sitz bone, and my pain is more towards the midline, and the area was not even tender. In order to evoke pain, it takes the weight of my body on the sitz bones for a while before it hurts. Then it radiates inward. I had a follow-up MRI, and the radiologist did not see bursitis anywhere, but did see some fluid around the hamstring origins.

I've also had hysterectomy with anterior and posterior repairs, and pelvic physical therapy for a year. The PT says I have good coordination of pelvic floor muscles - no tightness or spasm. I'm wondering if anyone else has had pain in areas just outside the pudental nerve areas, especially the sitz bones even after the pudental nerve has been calmed down. If so, what was the cause? In the meantime, I'm waiting to see the long-term effect of the steroid and amniotic allograft.

[Violet M]

I'm not sure exactly what you mean by pain outside the pudendal nerve area. I had pain inside (medial to) the sit bones that was due to the pudendal neuralgia. I can't say for sure what else would be causing pain in that area.

Violet

[LauraBee]

Thanks for the reply, Violet. I guess I am trying to make sense of the block working well for just part of the area, and am casting about for an explanation... I read your interview with Dr. Jarnagin and hope to try amniotic allograft, and in order to do that, it needs to be a couple months post-steroid. When I called his office, they said the response to your interview has been tremendous. Thanks you for bringing his work to light. It is helping many people.

[Violet M]

Hi Laura,

The nerve blocks I had did not take away all of the pain either. With pudendal neuralgia there are often other problems in addition to the PN. After I had PNE surgery the primary pain source of the pain eventually faded away and then slowly the surrounding areas of pain calmed down too, but it took time. I used a TENS unit a couple of hours a day to get the surrounding muscles to calm down, I had some prolotherapy into the SI area, and I did some PT.

I hope the amniotic allograft injections will help you. Take care,

Violet

[Gretel]

I noticed that you said there are varying opinions with regards to the Stem Cell Allograft by Dr. Jarnagin, but I have been unable to find a posting of anyone who has had this procedure and posted about it on the website. I have searched under Dr. Jarnagin's name. Please guide me to how I can find such postings.

Thank you,

Gretel

[Violet M]

I don't remember that anyone has posted on the forum about having amniotic allograft injections from Dr. Jarnagin but I could be wrong.

Violet

[marcyjaslow]

Hi again.

Like Violet said, has anyone had any experience with the Amniotic Injectable Allograft for chronic PNE who does not only 1 shot?

[Gretel]

Gina H. has posted some interesting information on this website about Dr. Jarnagin's Allograft. Please read them. I am not very computer literate and I hope you will find what she has written and that it will help you. I am not here often as I hurt so badly when I sit even for a very short while; so I might not know when or if you were able to get my information. I hope this helps.

[Hopeitworks]

I have extreme pain sitting, and can only sit a couple hours total a day on a partially inflated donut cushion. Last week I had a pudental nerve block, and also had a long-acting steroid and amniotic allograft injected into the area. The first 24-hours after the block, I felt relief in the genitals, perineum, and rectal area: warmth rather than cold, and the bothersome tingling stopped. The doctor advised me to sit without a cushion that first 24-hours to see if the block worked in the targeted area. While I felt relief in the "middle", I still felt sharp and dull pain on the sitz bones, which radiated in towards the vagina after a few minutes of sitting. I'm wondering if there are other nerves that could be contributing to the pain.

Muddying the waters is the fact that a year and a half ago, I had an MRI, which showed partial tears at the hamstring origin and ischial bursitis. A cortisone injection at the bursa helped for two weeks. I also had platlet-rich plasma injections in the hamstring tendons. However, I don't think I can assume its bursitis causing the symptom, because when the doctor palpated the bursa, the location of the bursa seems to be more to the "outside" (lateral) of the sitz bone, and my pain is more towards the midline, and the area was not even tender. In order to evoke pain, it takes the weight of my body on the sitz bones for a while before it hurts. Then it radiates inward. I had a follow-up MRI, and the radiologist did not see bursitis anywhere, but did see some fluid around the hamstring origins.

I've also had hysterectomy with anterior and posterior repairs, and pelvic physical therapy for a year. The PT says I have good coordination of pelvic floor muscles - no tightness or spasm. I'm wondering if anyone else has had pain in areas just outside the pudental nerve areas, especially the sitz bones even after the pudental nerve has been calmed down. If so, what was the cause? In the meantime, I'm waiting to see the long-term effect of the steroid and amniotic allograft.

Did you have tingling in your clitoris?