Health Organization for Pudendal Education

Let me preface this with saying that I have lumbar scoliosis (28 degrees) and some thoracic hernias that cause dorsalgia and chest pain sometimes.

I never had lumbar problems, but the other day I woke up with some lumbar pain close to the spine.

2 weeks later, I wake up with big lumbar pain and a weird burning feeling on my scrotum / perineum / ass and some weird feelings in my legs (seems like sciatica, its numbness on the left leg and some needles on my right on, cold sensation on feet soles...).

Also pain on both buttocks when openin my legs or pressing on them. If I press on the sciatic nerve on my legs and thighs, it hurts as if it is irritated somewhere up the chain.

Im waiting for an MRI on my lumbar/sacral spine but im actually too scared after reading some stories here.

Is it possible that S1/L5 herniation and scoliosis or some issues in the sacrum are causing this? I didnt do anything the day before (maybe sit with a bit wrong posture).

The doctor in the ER said that its 100% that it comes from l5/s1 bulging disc but I read that pudendal nerve starts at S2...he also gave me pregabaline 75mg.

Im confused because this seems like sciatica+pudendal, so it makes sense that it starts at the back? I dont have lower back pain right now, so it also confused me why this neuralgia and sciatica persists.

Im debating between it being muscular (pelvis and such causing an entrapment of both nerves) or it being spine related.

Can this resolve by itself with PT if its a muscle or temporal nerve irritation?

Any indications on the best course of action?
Im thinking firsr get the MRI, then visit 2 Neurosurgeons + 1 Neurology doctor to get opinions and do PT for pelvic relaxation -> if that doesnt get me a clear diagnosis of the issue, go see an expert urologist in pudendal entrapment in my city-> pudendal nerve block to see if I improve.

Sorry for the structural mess of this post, I am very anxious and needed to get it off my chest.

Hi Victor,

It sounds like you are on the right track with being proactive and having a sensible plan for what to do next. It helps to have a clear diagnosis so you know what you are dealing with and then figuring out what treatments to pursue. Hopefully your doctors will be able to help you figure this out quickly. When I got my MRI's they also recommended a lumbosacral plexus MRI so you might want to ask about whether you need that in addition to the lumbosacral MRI.

It wouldn't hurt to go ahead and get an appointment with the urologist in your city who is knowledgeable about PN. Also, if you can find a PT who is knowledgeable about PN that would be good. But given your history of back issues, hopefully your PT will also be knowledgeable about evaluating you for musculoskeletal problems that could be causing your pain but that might not show up on an MRI, since an MRI doesn't always show things like pelvic misalignment or pelvic instability clearly.

It's understandable that this makes you anxious but hopefully the medication they prescribed will help ease your symptoms while you are pursuing an accurate diagnosis and treatment.

Violet