Botox in QLD

[Pafen]

Going to hopefully see a Dr Lumley at the Wesley in Brisbane. He is the head colorectal surgeon that also does sacral nerve stimulator implants. I would certainly like to try botox first because its less invasive.

[Pafen]

Oh i have recently seen an ortho who ruled out a labral tear via a hip MRI with contrast injection...Sorry for the late replies, been trying to adjust to new pain management drugs. Just started lyrica 75mg twice a day

Thanks for all the info on the botox.

[gcman]

Pafen
Do yourself a favour and contact PT Peter Dornan at Toowong in Brisbane. I had burning pain in the rectal area. Saw Dr Lumley without success. Was eventually referred to a PT in Brisbane who suggested it was a stretched pudendal nerve caused by weak pelvic muscles. Info on this site led me to find Peter Dornan who believes in many cases tension on the pudendal nerve is caused by lack of mobility in the SI joint which a PT can feel. He is one of THE men in this emerging medical field and is quite approachable. Send him an email describing your problem.
Good Luck-- gcman

[Pafen]

Cheers i have contacted Peter Dornan. He is willing to pass on the SI movements to my physiotherapist here because of the long distance of travel to his practice in Brisbane. My local physiotherapist has called Peter who explained the manipulations that need to be done. So i will start this soon. I will probably start going once/week as needed. However i have been told it will probably be a number of weeks before i know if the physio has helped.

Maybe when i am in brisbane next i will make an appointment with peter as well. I certainly do have longstanding pain in my right SI joint which gets quite annoying at times. However i never worried about this as I thought there was no relationship with the rectal pain.

I am guessing your saw Dr Lumley and he told you nothing was wrong with ya?

I am expecting a similar response seeing ive seen another colorectal surgeon in Brisbane who has no answers for me except another opinion and pain management. However I probably still will see Dr Lumley on the basis there is always a chance someone knows something that someone else doesnt. The more opinions the better chance of finding someone who can help you i believe.

I hope your treatments are going well for you.

[gcman]

Hello Pafen
The way its been explained to me is that if your SI joint has been immobile for some time even after its loosened up the pain will continue. This is because the PN has become hypersensitive and virtually anything sets the pain off. They reckon this is in the nature of nerve pain so the nerve has got to be retrained. As a result, improvement is slow. In my case I measure it about each 3 months, not days or weeks as you won't notice any real change. After approx 10 months of treatment and exercises I have had approx 55%--60% symptoms reduction which has freed up my life a lot. The main thing is it gives you hope, a light at the end of the tunnel but you need patience.
gcman

[Pafen]

I know what u mean by hypersensitive. For me I have found i can just move a certain way. Or even just going for a walk around uptown can set the pain off. Yet if i limit my activities my pain becomes more manageable. My right SI joint is aching as I type this so its very possible it has some relationship with my other pelvic pain.

Seeing you have been having some success with the physio I will certainly give it a really good go, How often are u having treatments? I will probably only be able to afford once a week maximum for a long term treatment plan over a period of months. Have you been able to start/resume any sort of exercise program since starting the physio that doesnt flare your pain up?

I was actually doing something not recommended....but i was determined to stay fit...Cycling...However it always made my rectal pain unbearable for the rest of the day afterwards. I have since stopped this and am probably becoming more unfit but at least my pain levels have dropped to a level where I wont have to increase my medication.

Are u also doing the SI/Pudendal Neuralgia exercise program from Peter Dornan?

[gcman]

Hello Pafen
I see Peter Dornan about each 3 weeks, want to keep theSIJ mobile. I do the exercises daily when I get up. Cycling is claimed to cause PN so I'd keep away from that. I find walking is ok. I'm not cured but I'm a lot better than I was which motivates you to keep going.

[gcman]

A few more points to note
1 PN can be caused by things other than a immobile SIJ which is supposed to cause tension in the nerve resulting in PN pain
2 A good PT should be able to feel the state of your SIJ. In my case the left side was restricted but the right side was
normal.
3 It may be worthwhile going to the trouble of seeing Peter Dornan to start off so he can check your SIJ . The SIJ thing is his field, most other health professionals don't seem to have a clue about this aspect

[Pafen]

Yeah its a process of elimination as well really....I have been identified as having problems with my right SIJ in it being much more restricted in movement than the left side. Peter has actually seen me once before, I just need to follow up with my current physio and start getting the manipulations done again as described by peter and a regular exercise program...I have Peters Pelvic Dysfunction program here.

Some surgeons have said to me that I probably didnt even need hemroid surgery and its probaby not related to my pain at all.

I have just started these exercises for the past 2 days...I will keep doing them everyday along with adding the ankle weights in the near future as described by Peter.

My physiotherapist also found that my piriformis muscle was extremely tight and contracted....very sore. He basically said it was a natural response from pain for these muscles to tighten up in the area. Perhaps these need to be worked on as well.

I am also eliminating other things......Another thing is to probably see a urologist and get a cystoscopy done. Have any of you followed this up? for Chronic Prostatitis? Can cause rectal pain I believe. My MRIs show a prostatic cyst which varies from 5-8mm in size. I have asked a urologist about it and basically been told its nothing to worry about.

I have already tried the antibiotics for chronic prostatitis with no change in symptoms. Funny thing is I dont have any pain with my bowel movements really, Pain feels like its in the muscles behind my bowel somewhere

Do any of you have similar pain symptoms?

Before all of my symptoms started I used to run 5kms most days, cycle etc...Up until about March 2011...I am only in my early 30s so i am really working on/seeing multiple specialists to fix this ASAP.

[Pafen]

Sunil,

I think physio is very worthwhile when you have had multiple tests/specialist visits with no answers. At least its affordable and non-invasive being safe.

Otherwise what options do we have beside pain management? or a trip to Sydney