Sciatic along with pudendal and perineal pain

[SLR]

Hi everyone,
I wanted to share a quick article in hopes that it may help someone else. For most of us trying to find the root cause of our pain in order to try and fix it, is usually a long very painful and frustrating journey. I have had daily chronic level 10 pain for 3 1/2 years, the doctors dismissed my pelvic pain as coming from my back. So I focused on my pelvis and had 2 unnecessary surgeries unfortunately. My sciatic symptoms greatly increased recently and I realized that I needed to refocus my attention more closely on my back. It has gotten so bad that I am very weak and am having difficulty even walking around the block in my neighborhood. Both of my legs feel like they are filled with sand.
I have a broad disc bulge with bilateral moderate stenosis and posterior annular tear at L5 S1. 3 days ago I had a diagnostic nerve block epidural with steroids at the L5 S1 disk space. About 15 min or so after the epidural I felt myself go numb, in every single area that I have pain. My genitals, my perineum, my buttocks, both my legs, as well as the area in between my buttocks where I have a lot of pain. I feel this has confirmed this is where my pain is coming from. I am sharing this because I think many providers are in the mindset that pelvic pain has to come from very specific levels of the sacrum or back. And when they looked at my MRI again after I was having saddle anesthesia I was simply told "you don't have cauda equina, its not pressing on the cauda equina". And that was the end of that. I have done a lot of research on this and its all very interconnected and there can also be variations. Sciatic has a direct link to chronic pain in the glutes and groin, there is a variant of sciatic where you may experience pain in the inner thighs, lower abdominal ache, anal pain, as well as pain and discomfort in the genital area. From what I've read The L4, L5, S1, S2, and S3 nerve roots join together to form the sciatic nerve, there the nerve roots exit the neural foramen in the vertebral column. If you have back issues, have sciatic pain, and a LOT of pudendal like pain like I do, it may be worth checking further into this. Now I wish I had pushed back harder 3 years ago. I'm posting the article below, it will pop up if you do a google search. I'll keep everyone updated on what the future brings as far as epidural response, and potential surgery in the near future. Prayers go out to all of you out there suffering right now, don't give up.

journals/sagepub.com
Perineal pain:think beyond gynaecological reasons

[Violet M]

Thanks for posting this article. It sounds like you are really on to something in your case. I remember Dr. Bautrant excluded patients with a spinal radiculopathy in his research on the treatment of pudendal neuralgia about 20 years ago, so I think it has been recognized for awhile that a spinal problem can cause similar symptoms as pudendal nerve entrapment, although p may include more symptoms than just in the genital area. That's one reason everyone should have an MRI to rule out any spinal issues -- and Dr. Antolak used to recommend an MRI of the lumbosacral plexus as well as the lumbosacral area. The problem is that some people can have a very abnormal MRI with no complaints of significant pain, while other people have a ton of pain with a normal looking MRI -- at least that's what I was told by an orthopedic surgeon. So diagnosis can be very tricky. But I think with the results of your epidural in combination with your MRI results you can be pretty confident in the diagnosis.

Wishing you the best if you decide to have surgery. I would be interested to hear how it goes for you.

Violet