Health Organization for Pudendal Education

I can't find any info. saying nerve blocks are working for people. I only hear negative. I understand they use numbing stuff when they do it so that gives relief for a while, but that is about it. Nothing that lasts for 2 months or more.

I understand also that they are used to help with diagnosis.

I am a year out from surgery and the pain management center wants me to try it and I just can't find anything saying they are a good idea or that they work.

Let me know if I am wrong please. I just feel like they are very expensive, not covered by ins. and do little for pain management.

Thanks for letting me know if they worked for you.

Kat, I've not seen any evidence that they are effective post-op and like you say there are risks involved. Now, watch someone come on and say they were cured by nerve blocks post-op! I'm just saying I don't remember ever hearing of it happen.

I really think their only purpose is to help in the diagnoses and fill in the pieces of the puzzle which PN/PNE seems to be.

They helped me know that I'd tried all I could to get well without going on to surgery. I think they have some use in other parts of the body for inflammation, but I don't believe they can effect change when you have a mechanical entrapment.

I do know people who have used nerve blocks to successfully cope with bad but temporary pain flares post op, but to my knowledge that's the only reason to use them post op--ie, not to keep looking for a cure.

As your surgery was a year ago, any nerve pain from a successfully decompressed nerve could be from scar tissue that can form from around 6 months (I believe) after surgery so it depends on if your pain now is the 'same spot'' nerve related, (could be scar tissue) and I guess would have to be different now than from post, successful, surgery OR from a different part of the nerve ( why would it be if all successfully decompressed, but still worth considering) or one of it's branches which may not have been accessed during surgery? ?
If the blocks are to be targeted to individual branches they may be able to reveal a separate area of entrapment or irritation. Dr Hibner has recently reported that he is working this way with patients (not sure if anyone else is). Theoretically, it makes sense but I guess the blocks would need to be done by the right person AND they are essentially diagnostic again and not a cure.
I think it's Dr Bautrant who clinically examines a patient to determine where along the nerve or branches an entrapment may be but a knowledgeable physio may be able to do something similar.
These are the areas that the branches innervate and affect.
Inferior rectal branch
– anal canal, caudal third of rectum, skin around anus
– Muscles: posterior portion of external anal sphincter
• Perineal branch
– Inferior third of vagina and urethra, skin of scrotum/labia
– Muscles: transverse perineum, bulbospongiosus,
ischiocavernosus, urethral sphincter, anterior portion of EAS
• Dorsal Nerve of clitoris/penis
– Skin of penis/clitoris.
Wishing you luck.

Hi Kat,

I thought that Conway cured you why do u need blocks?

To be clear:

Conway cured me of the entrappments and now the nerves have to heal.

Nerves heal slowly from tip to root. My nerves healed 2 inches this year and they have a long way to go before they are healed all the way to my spine.

I'm asking about nerve blocks for pain relief during the rest of my healing time.

I hope that is clear. The surgery cured what it was supposed to. Surgery can't make nerves heal faster then they heal naturally. I'm just getting impatient waiting for the rest of the burning to stop and I'm wanting a quick fix.

Thanks for asking the question and let me know if more explanation is needed.

What do you make of this report? Do you think this report is accurate? Maybe these people just had pn not pne?

http://www.centerforurologicandpelvicpa ... 5B1%5D.pdf

Laura wrote:Maybe these people just had pn not pne?

That's the impression I got from the article, too, Laura. I've yet to have had contact with anyone who has been "cured" by nerve blocks. I thought the follow exerpt was interesting:

"Why do blocks fail?
A major reason that blocks fail is patient activity. When you feel better you return to the
’old’ activities that repeat the damage to the nerve. Self-care is a continuing, perhaps lifelong,
treatment process. Blocks can fail if the medicines are not placed near the nerve.
Complete accuracy is not possible with any injection techniques available.
When a series of blocks is diagnostic or has a limited duration of effective pain and
symptom control, we recommend surgical decompression of the pudendal nerve. In many
patients the reason for lack of effective response to pudendal blocks is apparent. The
nerve is simply too damaged by compression to permit any healing after the injections.
The nerve may be compressed higher than the usual locations for injection. Occasionally
we see nerves with damage that will be permanent and will not respond to any treatments.
Research to help this group is necessary."

So, my next question is: Anyone out there who had nerve blocks AFTER decompression surgery? What were the results?

Hi Kat,
Thank you very much for clarifying what you deem as a sucessful surgery. I can understand the confusion amongst the community members (myself included) about being "cured", yet for the most part, disabled and remaining in horrible pain. Disabled and high level pain just doesn't smack with "cured". But after your clarification, I can see where you're coming from now.
I agree with you - the purpose of your surgery was to decompress your nerves and (hopefully) that was achieved within the boundaries of the surgical approach you underwent. I don't believe any surgeon has control over how our nerves heal after decompression. And yes ... they do take a very long time heal. More for some than others, depending on the extent of injury to the nerves. I think "success" means different things to different people and that's OK. For instance, I have a close friend who told me that "I have no business posting my surgical update under Success Stories because I'm not able to sit comfortably for hours on end". I don't agree. I'm looking at the big picture here - significantly less pain and significantly more functional. For me; that's a success. My personal point of view is that the decompression surgery is not designed to "fix" you, but more of a way to remove a roadblock. Healing is up to the individual and their unique pathologies.
In regards to the above post "Why nerve blocks fail", I think a good deal of it also applies to post-op patients and this is a very important statement:

Karyn wrote:Self-care is a continuing, perhaps lifelong,
treatment process.

I know there are some who would find this rather upsetting, but I've come to terms with it and am in for the long haul. Whatever it takes.
I wish you the best, Kat. I admire your positive attitude and perserverance with trying to obtain less pain and more independence.
Hugs,
Karyn