mri of buttocks

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mri of buttocks

Postby river133 » Tue Feb 11, 2014 1:28 am

It has been 3 years since I had my tg surgery with Dr.Antalok. My pudendal pain is decreasing slowly. I am able to sit as long as I am on my meds for a half hour at the most.
I had surgery with Dr. Chambi on each side for decompression of the sciatic, pudendal., peroneol, pfcn. I am still having a lot of pain. Dr Chambi suggested I have a mri of the buttocks, I did last week here in Mn. The clinic called a while ago and said the MRI is normal, nothing around the sciatic, pud
endal or sacrum. So how do I explain my pain to my gp.? I am not one to make up pain. Please help me , Iam feeling so helpless again.
Surgery Jan.05 2011 TG with Dr Antalok. Dr.Chambi May of 2012 showed injury from a fall on back, 11 years ago. My piriformis muscle caused a large amount of fibrosis .My sciatic nerve was growing through the piriformis muscle which caused a bifid p.muscle. . Dr Chambi decompressed the sciatic,pudendal,pfcn ,and peroneal nerves. I hope to have a nuerostimulator put in to help with the sciatic pain that never goes away. Most days are better with the pudendal if I do not sit at all.
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Re: mri of buttocks

Postby nyt » Tue Feb 11, 2014 2:08 am

It is difficult to image the nerves in the pelvis especially the pudendal nerve because it is a very small nerve. It is very common for us to have normal MRI's but that doesn't mean you don't have problems. I know the first MRI I had with my local radiology group showed it was normal but I clearly had entrapment of the obturator and both pudendal nerves at the time of surgery. MRI is really used to rule-out any other pathology that might explain your pain. If you want an MRI that focuses on the pudendal nerve you need to go see Dr. Kalinkin in Phoenix, AZ or Dr. Potter in NYC as they have developed specialized protocols to image the pudendal nerve. Another option is the MRN that Dr. Filler does.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
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Re: mri of buttocks

Postby kathyd » Fri Feb 14, 2014 11:25 pm

Hi NYT and everyone
Yes I can second that regarding the MRN.
I havent' had one yet but thinking about seeing a prominent pain mgmt doc across the country in CA.
He actually asks you to have an MRN done out there at a center he sends you before he treats you for pain.. he said the MRN can visualize the intricacies of nerves much more clearly.. and it would be great as he said, to find the root of the issue rather than just to treat it the pain.

I did have the Potter MRI twice in 2009 and 2010, and no particular indication of pudendal issues showed up,, tho at the time I had sit bone pain and IC issues.. Now I anal pain also.
The main standout back then was pelvic varices in the area of the PN and a labral tear (among a few other things) but no entrapment unless you count the contraversial pelvic varices.
I attended to those (on one side ) had embolizied, with no change so, didn' have the other side done.
I also had the labral tear surgery in 2009--waste of time for me I had no hip pain to begi n with but my doc was a big believer in the connection between hip tears and pelvic ..So I followed her advice.

I really hope this MRN would show this doctor out west (if I do go) more specific info?
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Re: mri of buttocks

Postby Violet M » Sat Feb 15, 2014 1:51 pm

River, have you already tried ketamine for possible central sensitization? When surgery doesn't fix pain often it's a matter of finding other therapies that will help calm the nerves down like ketamine, water therapy, etc. Neurostimulation does work well for some people. I was just on the phone the other night with a woman who had a neurostimulator implant and most of her pain is gone. So keep your courage up and fight until you find something that works for you.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: mri of buttocks

Postby kathyd » Sun Feb 16, 2014 6:46 pm

Hi Violet,
Ive tried many things to address my severe anal rectal throbbing buut had heard of "water therapy".
Could u tells what it is?
thx !
Kathy
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Re: mri of buttocks

Postby river133 » Mon Feb 17, 2014 6:46 pm

My gp and physciatrist, really played down the nuerostimulator. Said he has seen some really bad results from the stimulators. It would simply in my mind need to see a
Dr. that has had experience with the pudendal , I read something about the sciatic and gluteal nerves being confused. The glueteal has symptoms similar to the sciatic. Back in the buttock, and dowm the leg and foot
. I will be having a emg in a couple of weeks. The same Dr that tested me before I was diagnosed with pne. Told me at the time that I have nerves like an 18 yr.old. I was in so much

pain at the time.
He told me a few weeks ago he knew nothing about the pudendal nerve..He said, also his clinical test showed no evidence of sciatic problems. So at that time I asked him, why should I have the emg? My thinking of course was , no question in my mind did i have anything but.He said, well, don't you want to come in and find outwhere your pain is coming from?. So, since my gp now has seen the results of the MRI, showing no problems surrounding the pudendal or sciatic , she wants me to go hrough with the emg. This Dr wueygen (pronounced When).will not find any irregularities I suspect.
I do use the ten unit for the sciatic. I can not be without it.I have been off and on of opiates for the past 6 years. Having a nuerostimulator would be a welcome change so I would be able to be off of the drugs.
Surgery Jan.05 2011 TG with Dr Antalok. Dr.Chambi May of 2012 showed injury from a fall on back, 11 years ago. My piriformis muscle caused a large amount of fibrosis .My sciatic nerve was growing through the piriformis muscle which caused a bifid p.muscle. . Dr Chambi decompressed the sciatic,pudendal,pfcn ,and peroneal nerves. I hope to have a nuerostimulator put in to help with the sciatic pain that never goes away. Most days are better with the pudendal if I do not sit at all.
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Re: mri of buttocks

Postby Violet M » Sun Feb 23, 2014 2:24 pm

kathyd wrote:Hi Violet,
Ive tried many things to address my severe anal rectal throbbing buut had heard of "water therapy".
Could u tells what it is?
thx !
Kathy


I don't know many details about water therapy Kathy but someone named Vanessa wrote a book about how it cured her. As I recall she first started out just floating in a warm pool of water and later progressed to gentle movements. Maybe someone who read the book could describe more. I guess I sort of tried it on a smaller scale when I did alternating warm/cold sitz baths that really helped me from going insane sometimes because they have a very soothing effect on the pelvic nerves and muscles. I used a child's pool floatie to sit on. But I think floating in a warm therapy pool would have been even better because it would help relax your entire body.

Violet
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.
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Re: mri of buttocks

Postby janetm2 » Sun Feb 23, 2014 6:24 pm

Just to let you know there is a range of water therapies. Mine was to build core strength post surgery to help with SIJD. I basically walked back and forth across the pool forwards, backwards, sideways, etc. Also I was standing at the side inside the pool and pulling in stomach while pushing a kickboard down from flat on the water, then stand it on end and push away and side to side. It helped with the core strength and walking is less stressful in the water.
Janet
2007-08 pelvic muscles spasms (per colon-rectal dr.) treated by ElectroGalvanicStimulis(EGS). 6/27/10 sat too long on a hard chair- spasms, EGS not work Botox help, spine pain dr cortisone shots in coccyx help, still pain, PT found PNE & sent me to Dr Marvel nerve blocks & MRN, TG left surgery 5/9/11. I have chronic bunion pain started/surgery at age 21. TG gave me back enough sitting to keep my job and join in some social activities. I wish the best to everyone!
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Re: mri of buttocks

Postby kathyd » Sun Feb 23, 2014 7:32 pm

Thx Violet and Janet,
I want to try both ideas at a nearby gym.. They have a heated pool and a hot tub.
I have been advised to swim over the past few years, but stopped in the past year or so due to to increased pain and being too demoralized to have the energy.Just getting out boosts my morale..so I will try it.
I like your idea of alternating the water temps Violet. i assume it kinda tricks the nervous system and thus relaxes it. That the is the goal we have: to get the CNS to stop firing constant pain signals and re-learn a new pattern.
Is is okay to stay in each temperature tub just a short time? ..( I can hold my body in such a way that my butt won't rub against the tub surfaces,but can't sit on any of the ring type devices as yet.

Also the water walking idea is good Janet-- being weightless I remember not getting the anal pain from walking in the pool.
I remember doing it a lot after the nerve surgery as we have a pool in our yard (for summer months)..It didn' t re-hab me or prevent pain as the surgeon suggested,
but it was good exercise, and a good way to keep moving

Thx ladies.
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Re: mri of buttocks

Postby kathyd » Sun Feb 23, 2014 7:37 pm

One more quick question
Would a hot tub be too hot for warm water therapy...
We have one but have temp problems with it and it tends to be a bit too hot for me... tho my husband loves it that way as does my son, who has achey muscles from hockey. The hot tub at our gym seems pretty hot as well.
Thx!
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