Health Organization for Pudendal Education

I recently sent a packet of information to Chiropractor Kirk Andrews in Ontario Canada. He uses Shockwave physical therapy for pudendal nerve issues. I have been encouraged by the report of Brian and MNMom, who have also had shockwave therapy with positive results. If I decide to got to Canada for this therapy, I intend to document the visit here.

I continue to have mostly good days, although too much sitting makes me sore by the end of the day. I take only one medication, 1 mg Clonazepam, and this helps my perineum relax. With daily swimming and/or walking, I am able to get through each day. I want to be much more active, but know that if I push too hard, I will only traumatize the nerve again and have a set-back. I am working full-time, sitting about 5 hours per day off an on. I do not sit, or try not to sit at any other time during the day. I find walking/slow running very helpful in relaxing the perineum and peri-anal areas.

kone

Yes, Konedog, please let us know how it goes with Dr. Andrew if you decide to try his treatment. Good luck!

Thanks for takling time to help!!!!

Update: I had a telephone consult with Dr. Kirk Andrews in Ontario, Canada. He was very helpful and answered all my questions in regards to Shockwave therapy. I am ready to give it a try to see if improvements can be gained. I will make an appointment with him for this summer. The therapy is one week in duration, and he says it is quite painful. Shockwave therapy breaks down scar tissues and allows the body to heal itself. I really do not trust the surgical approach, as the results are too spotty and unreliable. Plus, I cannot afford to be idle for many months post-surgery. So I will try the therapy and will document it here after it is completed. My goal is to get my life back, and if shockwave therapy helps, then it will be worth the pain and costs involved.

I continue to walk/run on most days, and am up to 4-5 miles now. I still have pain while sitting, and the pain is centered just anterior to the rectal area in the tissues between the rectum and the pubic bone. I take 1 mg Clonazepam daily for perineal relaxation, and this really helps. I am staying positive, praying for help from the Lord, and believe without doubt that an answer will be found to cure this condition.

kone

Hi konedog,

Have you considered phased re-introduction of sitting? For me it was crucial to recovery and your symptoms sound very similar to mine. The basic idea is to only sit for a short fixed period four times a day (with about three hours between sittings) and then each week increase the sitting time by 10%. If you follow it religiously it may well deliver some great results, because you would essentially be teaching the nerve how to sit again, rather than perpetually crossing the 'red line' of too much neural irritation. If you start with 10 minutes x 4, then in about 6 months, theoretically, you'd be up to about 3 hours x 4. If you find that you're not able to stand or kneel because of your job, then try using a U cushion for the times in between sittings. In conjunction with your swimming and walking I think it might work really well for you.

Sitting is one of the things that aggravate my condition, so i avoid sitting as much as possible. Squatting is also another thing I should not do. So no, I have not tried to phase in a sitting regimen. I feel better when I sit as little as possible, so at this time I don't think sitting, even for a minute would be helpful. I do thank you for the suggestion however. I am glad you got better through this therapy. When I reach that point, I will certainly employ it. Thanks.

kone

Good luck in Cornwall konedog, I look forward to reading your success story It is something that I would love to try too. Thanks for offering to post your experiences.
All the best,
Helen

Hi all,

I have not posted for some time. I have been going to a physical therapist about once every 6 weeks. She has taught me some home self-therapy techniques that have been of help that I wish to share. The techniques she taught me were the external and internal massage of trigger points. I used to never apply pressure to where it hurt, figuring that would make it worse, but going by the diagram she gave me, I have been applying pressure to break up muscular trigger points in my perineum and I have a lot less tightness and pain. I am actually sitting as I write this post; usually I kneel. I found a book somewhat helpful in my trigger point exercises, it is called "A Headache in the Pelvis". The book teaches paradoxical relaxation and trigger point massage, as well as stretching exercises. I do my trigger point exercises in the AM and PM while taking a shower. The warmth of the shower relaxes the muscles and I find it easier to do the pressure point applications while in the shower. I do this standing up, but it can be done sitting or lying down too. My main trigger point is the band of tissue that is just anterior (forward) of the rectum. So I place pressure on it for 30 seconds, stretching it until it yields and relaxes. The therapist taught me how to treat trigger points externally and internally, going through the rectum. I think both approaches have helped. At first, I would only get relief for perhaps an hour or more, but now, after doing this technique for a month or more, I find the relief lasts most of the day and night. The rectal pressure point techniques were quite uncomfortable initially, but in the long run, these are perhaps the most beneficial, as i can get at certain muscles from no other approach.

I can sit again in the car (on a cushion) and can sit at work again (on a cushion) without getting sore afterwards. I am also walking/running 5-6 times a week. All in all, I am very encouraged by the progress. I have a steroid injection scheduled for July 3rd, but I may cancel it as I am making progress and may not need it.

kone

Brilliant Kone,
I don't think the physiotherapy aspect of pelvic problems should ever be underestimated. It's great they you were given daily 'instructions' and that this has helped so much. Obviously for now, and the improvement you have . . . . . but if anything recurs or begins to deteriorate in the future you are your own therapist.
Take care,
Helen

Thanks for the update, Kone. Glad you are making some progress without having surgery.

Best,

Violet