Did labral tear surgery reduce your PN/pelvic/perineal pain?

[beverley]

I just want to write a quick update. I had a ilioinguinal nerve block/injection in my abdomen both for diagnostic and therapeutic purposes -- the block was positive in that it blocked my "hip" and pelvic pain for about 12 hours. Seven days later the hip pain is significantly reduced by the block but the pelvic pain (which is primarily clitoral) hasnt really improved as i am 100% sure the nerve compression is coming from my spine (L1/L2) and the block was done in my belly. I did this after a pudendal block that was negative and pelvic floor PT that wasn't working and all the hip stuff that you can read above. The bottom line is the pain is being generated from my back which most doctors who aren't well verse in pelvic pain will deny is possible (I had 5 docs tell me I couldn't have ilioinguinal neuralgia unless I had had abdominal surgery). My next step is to have injections at L1/L2 to see if I can reduce the irritation and inflammation to the ilioinguinal nerve. bottom line is my pain was coming from nerve compression in my spine (my MRI show only mild degeneration) and not my hip and I probably had unnecessary hip surgery. I know my case is unusual but I thought I would share it incase someone else might benefit from this info who has "hip" pain -- the ilioinguinal nerve run in front of your hip!!







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[kathyd]

Thx Beverlly,
for posting this info.
So glad you are feeling better and that you discovered this info to help you!
I remember you are in the NY area?
What docs helped you in your detective work?
I have found that every pain doc I meet is in the dark about PN pain, and i am exhausted at trying to figure out my pain source after 8 years,,
Hubby is too.
I can can get by but cant sit at all without throbbing pain in anus plus afterpain... I have 3 kids and need to be available to them.
Dr Coady -Now retired-- was good and kind, but the referrals she sent me to were mostly useless or dis- interested.

Is there a decent doc that you like?
thx so much.

Kathy

[Karyn]

Hi Beverly,

Thanks very much for posting your update. Personally, I don't think your case is unusual at all. I've posted this link somewhere else on the forum, but in case you missed it:

http://www.maitrise-orthop.com/corpusma ... ndex.shtml

I sincerely wish you the very best with your injections. I've previously pursued diagnostics for this condition but have not been unsuccessful.

Kind regards,
Karyn

[beverley]

I go to dr harris who is dr coadys partner (even though she retired). I agree with you that their referrals are not that great and I don't use them for that. I went to dr greg lutz who is a physiatist at HSS who knows nothing about pelvic pain but he did the epidural and I really liked him. I go to amy stein at beyond basics and she has really worked with me to uncover my very complicated case. and then I go to a pain management doc at HSS (dr richman) who WONT take pelvic pain/pudendal nerve patients so I had to get in through a referral from DR coleman and say my pain was primarily "hip" pain. he is kind of a jerk but he knows what he is doing and I am having pulsed radio frequency on t12-l3 with him.

[Julia]

Hi Julia,
I just happened to read your post and we sound so similar that I had to reply. I also had a regular MRI done on both my hips and the results were normal. My GP wasn't convinced with the results and consulted with a colleague in Edmonton who said that a High Resolution MRI would show a hip labral tear. It turned out I had labral tears in both my hips with an impingement on the left and 2 labral cysts on the right. Although the High Resolution MRI did show the labral tears the orthopedic surgeon said I should have had an MRI with contrast. I see that your post was from March and I'm hoping you already had the MRI you need.

Hi Girl80! I am so sorry, I did not see your message until now. I sent you a private message but I am not sure it went through. Thanks for reaching out to me and letting me know that you had similar symptoms to mine. I would love to know a little bit more about your symptoms and how you are doing now. Did you have the surgery?

I finally did get the MRI with contrast and though the radiologist in Guelph, Ontario found no evidence of labral tear, I had 3 hours of pain relief from the lidocaine injection (freezing into the joint). When I found out that this can be a diagnostic tool for determining that the pain is coming from within the joint, I sent my mri and xray to Dr. Nho and Dr. Philippon (respected surgeons in the States ) for a second opinion on the images. They both saw the same thing: anterior superior labral hip tear with cam impingement. Finally, I was getting somewhere! I got in with a surgeon in Toronto (Dr. Lucas Murnaghan) and have booked my surgery for November of this year. Trying to do all I can now to be prepared and ensure a smooth recovery, I know I still have a lot of hard work ahead of me, but I am grateful to this group for making me aware of labral tears and their relationship to pelvic pain/PN.

How are the other ladies in this thread doing? I would love to hear from you!

I am active on this facebook group for Labral tears and FAI if anyone would like to chat on there. It is a great source of support and information. https://www.facebook.com/groups/FAIhip/

[alexm]

Hello all,

I just thought I should also add my grain o salt. I had two fai labral scopes in 07 & 12 2013. I was dooing pretty well up until three weeks ago, when the PN pain flared up agian. I was doingabout 60/70% better up to that point. It is very, very difficult to come back to the samepoint after such a positive moment. I am hoping it is just a hitch. I seemd to flare when I changed orthopedic innersoles. Any connection possible? Has anyone else had a major flare up after months of relief following fai / labral tear surgery?

I also have some physio planned with Mr Guerineau, who works with the Nantes team over ere in France. It seemed to help last time. He seems to think that mine is a mainly muscular issue, as I have a lot of ups nd downs / periods with and without pain.

Anyhow, much love to you all. Don't forget to let me know if you have been o are going through similar experiences. Lernica, please tell me you are still doing well? I really hope you are.

Al
x

[kathyd]

Hi Beverely
I have been offline for awhile..Just wanted to wish you luck with pulsed radio freq. in December?
Hope it helps and pls keep us posted..
I understand how hard it is to get in with docs/ PTs ....Amy Stein was very kind to me but I was not making progress as I feared letting her do much rectal PT due to my lack of pain control.
Anyway hubby who is my driver cannot drive me weekly to NYC to see Amy for about 9mos which she says I might need.
its hard for him to make that commitment, due to his job.
Sorry Dr R at HSS was so unwliing to help PN patients...they all want the typical easier to treat pain patients... ie shoulder, neck, hip etc..

anyway Ive found a great PT right in my area of NJ .seems very savvy and works with a symtathetic caring urologist...Finally!
So am praying for some good results.
She s going out on maternity soon.
(this the 3rd time Ive found a good PT who then went out on maternity leave,,but she will stay in touch, and will be back soon.
Good luck...
Kathy

[DakotaGirl]

Hi
I have been reading all if these posts about Labral tears and fai impingement.
Can anyone tell me exactly what kind of symptoms the tear/impingement causes as opposed to other causes of PN?
I have been told that the hip probably is not the source of pain because it hurts near the back of my thigh? When I tighten my glute the nerve pain shoots or near the rectal muscles.
Please help me figure out where the pain is originating from!!
What are the symptoms of hip pathology? I was told mostly groin pain and the pt said some lower back pain. Could my glute have an injury/entrapping the nerve from straining for BM that will never heal?
There has to be some ideas. The doctors keep telling me it can be from this or it can't be from that.
Anyone who had a Labral tear-were you complaining of hip flexor pain prior to the sitting pain began? Thank you.

[alexm]

Karyn,

The link you posted regarding Maigne syndrome no longer works. Do you have one which works? The team here in Nantes (prof Rober, Prof Labat, etc) have just said it is a component in my case.

Thanks,
Al

[DakotaGirl]

That is the question for me. How can I tell if the hip is the major contributor to the rest of the spasms and weakness and tightness in all of the surround muscles and ligaments. I don't want surgery only to find out it was my back or some sort of tendinopathy that is still the pain generator. Or the pn is causing spasm.
One clue I do have that's odd is whenever my peristalsis kicks into action and moves any of the rectal muscles to move things along I get sort of stinging pain and spasms and twitching in the whole butt/gluteal fold. Also if I did a kegel it sets things off stinging. Same if I close my keg inward towards the groin.
I sound crazy and feel crazy and I want to work it out. Thanks so much for replying. DG