official report. Where do I go from here? Neurologist PT?

[Aple2017]

Thus is pretty mych the report that Inhave received
"Because of the coccygeal pain, diagnostics were firstly focused on the coccyges.
The tests, standing on 1 leg did not demonstrate a blocking SI joint, lateroflexion
was asymmetric Ri>Le. Active Straight Leg Raising was symmetric but scoring 1-
2. Palpation was painful with high tense on the iliococcygeal and coccygeal
muscles. Stability of the core is not optimal.
Position of the tailbone was not well palpable because of the pain.

Vaginal palpation
Superficial pelvic floor area (levator ani, transversus perinei) was performing with
a high situative tone (responding on the finger and with fear of pain). In left
deeper area and coccygeal area pain scores were high.
Anal palpationHigh superficial tone on sphincter complex and intact. Mobilizing
the coccyx was very painful and seemed a bit out of position to the right with also
a rotation to the right.
Measurements with MAPLe electrode vaginally: Base tone 4-5uV (normal value
1.5uV). Especially the deeper part left demonstrated this high tone.Normal onset
to contraction and offset relaxation. High tone deep left could not be relaxed (ilio
and coccygeal musculature).

"Pudendal nerve.
Alcock canal both sides irritated demonstrating some entrapment of the pudendal
nerve. Sensibility para-vaginally was tested with the cotton tip. Both sites were
irritated and triggering the tickling pain in the coital area, concluding that the
anterior root of the pudendal nerve is affected. "

What should I do next? See a therapist, neurologist or eait amd see if the pain resolves on its own. I am so co fused with the rezults. And all of these muscles. A bit embarassing how medically illiterate I can be.

[Aple2017]

Can an entrapment be diagnosed without MRI?

[Violet M]

Whether to wait or pursue treatment is really an individual decision. I typically prefer to pursue treatment than to wait but if you decide on treatment, I think starting with conservative treatments is a good idea. Did this PT think that you would benefit from pelvic floor PT? Is it possible for you to try it for a couple of months?

I did not have an MRI to diagnose pudendal nerve entrapment. My understanding from what some surgeons have reported is that MRI's aren't always accurate in diagnosing PNE. I think it is important to have an MRI to rule out anything obvious such as a pelvic tumor but it won't necessarily give you an accurate diagnosis of an entrapment.

Violet

[Aple2017]

I am trying to find here someone who specializes in pelvic floor dysfunction. So far I have fpund one woman who might be able to help. However, I do have a question as to what I should expect from this therapy? Have you ever had it? I went to one therapis but I do not think she was the right choice as she just massaged my hips and bellow my buttocks. Is that what is supposed tp happen when they treay PFD and pudendal nerve issues?
I made an apt with another GP who could refer me to someone he might know.
Thank you for your patience, Violet.

[April]

Hi Apl,

What you've described sounds like what I think many PTs do for pn. My PT does not touch the nerve directly; instead, she gets rid of all the many trigger points that are in the surrounding muscles, and she does this with a procedure that is a bit like a massage. She, in essence, massages the muscles to find the trigger points and then applies a bit of pressure to each one to get rid of them. So, this may be what the PT was doing. If you do go back to that pt, you could ask about the purpose of each technique she's using, so you can be sure that she's doing things that she thinks will help the pn.

April

[Aple2017]

Thank you, April. I thought the massage had to be performed inside the vagina.

[Violet M]

This page http://www.pudendalhope.info/node/50 gives an overview of what some of the PT's do and some things to avoid. I hope you can find someone who can help you.

Violet