Question

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Laura
Posts: 110
Joined: Sun Jul 17, 2011 9:19 pm
Location: Astoria, Oregon

Question

Post by Laura »

Is my thinking right that the burning pain is from the nerve and the achy like someone kicked you between the legs is the tight muscle pain?
I'm taking 10mg amiltryptaline 2 times per day and 100mg gabapentin 3 times per day. It's been helping with the burning, but not achy pain. I finally got a referral for pt. I don't know if pt knows anything about pelvic floor dysfunction, but my Dr will not give me referral for pts on list cause they are all outside of network. I am trying to be as proactive as possible so I bought Amy Stein's book 'Healing Pelvic Pain' and have been doing the exercises in the book. I think I found a trigger point. All of my pain has been just on my left side and so is this trigger point. It is in the area where your upper thigh meets your perineum in the hollow area. Is that a muscle there? I massage the area as suggested but it doesn't seem to go away. How long does it take for trigger points to ease up? I've asked my Dr. twice for muscle relaxers and he won't give them to me. Bm's are my major pain flairs. I avoid sitting but how do you avoid bm. :roll:
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curliegirlie74
Posts: 5
Joined: Tue Aug 23, 2011 4:14 am
Location: NW Indiana, USA
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Re: Question

Post by curliegirlie74 »

I'm not sure about your 1st question but that's a great one to know and I'm curious about that also!
I'm taking Gabapentin 100mg pills ~ started off taking 300 mg a day for 7 days and then he bumped it up to 900 mg a day and I also have felt a little bit of pain relief but not as much as I was hoping for. I still have the burning, aching, stabbing, numbness, tingling, vice butt gripping pains that are now going down both my legs also.
I can't tell you whether or not physical therapy will help you as I just went last week for my 1st consultation which I have to be honest I left there drove about 1/2 a block and I had a lightning bolt feeling go down my left leg and into the top left foot at the end of my last 3 toes and the rest of the night and about 3-4 days afterwards I was in horrible pain. But they say with PT for anything that ails you you'll have pain before it gets better. So I'm willing to keep going to see if it eventually helps me out. My PT does specialize in PFD & PNE/PN so I'm blessed to have her right in the town where I live! Most people have to drive a long way to see one. She did tell me NOT to seek chiropractic care as it took this long to feel the way I do and if I see him it will be like getting a very fast treatment and it will throw the rest of my body into severe spasms. She also said that people who are suffering the way we are should seek a PT who does specialize in this area or they could ultimately make your symptoms worse as they don't fully understand the anatomy of our pelvic regions.
I go back again tomorrow for my 1st real PT treatment and I'll have to get back to you to let you know how I feel. She did also say DON'T do any pelvic strengthening kegals at this point because everything is inflamed and that will only make everything more inflamed and more painful. She said work on relaxing and stretching everything out first and once you have that worked out (which could take months) then work on the strengthening portion of your pelvic region.
The pain you described as your "trigger point" is where I have a lot of pain myself but mine is on both sides and my PT said the Pudendal Nerve runs along that region and at my last appointment she hooked me to a machine and places these suction cup probes there and a few other places that are sup. to decrease the transmission of pain signals to my brain. I'm not sure if rubbing that part would help ease your pain or not? I've read that muscle relaxers can be helpful to us if all of our pelvic muslces are inflamed creating tension on our pudendal nerve. Maybe your doctor wants a report from the PT before he'll prescribe the muscle relaxers. Ask your PT after your first evaluation if he thinks you would benefit from them and have him suggest that to your doctor.
I have the same issues, I have a flair before & after my bm's and they usually will last a great portion of my day then with not much activity I'm suffering pretty bad every night.
I hope & pray your PT can help you and you get some pain relief! Hopefully some other people can help you out further with your questions as I'm just learning a lot of this myself.
1 childbirth w/ a 4th degree laceration, repaired in the birthing room, no ultrasound @ 6 wk. checkup in 2001. 2005 After many Dr. visits misdiagnosed, fecal incontinence, 2 colon surgeries, severe/chronic low back pain, numbness, tingling, burning, itching and the list goes on. My colon/rectal surgeon did a PNMLT test and a rectal EMG on me which determined there was nerve damage which he diagnosed as bilateral pudendal neuropathy.
calluna
Posts: 1058
Joined: Mon Sep 27, 2010 11:57 pm

Re: Question

Post by calluna »

I agree, it is really hard to tell what is the reason for each sort of pain. I get a feeling like a very bad period pain, dragging, aching, and yes - feeling like you've been kicked. Plus the usual burning etc. I don't know whether I have tight muscles - my whole pelvic floor has been replaced/reinforced with mesh, the muscles had become detached from their usual points of attachment.

One thing I would say is about the gabapentin. Usually they say not to expect any pain relief at all until the dosage gets up to 1800mg. Many people need to take it much higher than that, to get pain relief.

So Laura, if you are getting some pain relief at your current dose of 300mg, that is good news indeed. And curliegirlie, again it is very good news that you are feeling some help at 900mg. Both of you may find that if your doctor feels it is appropriate to take the dose higher, you get better pain relief.

In case it is helpful - here is a link to my pain clinic's website. That is the analgesic ladder for neuropathic pain - if you scroll down a little then you will find the dosing schedule for gabapentin. As you can see, they take gabapentin up to 1200mg taken three times a day, if necessary.
nyt
Posts: 1165
Joined: Sun Oct 31, 2010 3:24 am

Re: Question

Post by nyt »

Laura, trigger points can be EXTREMELY stubborn to get rid of. It can take a long time with daily treatments and sometimes even need trigger point injections. What about a massage therapist to work high up on your inner thigh? I have found even though I do work on myself that my massage therapist and pelvic floor PT can manage to work on things and get them to ease up for a day or two. It should be in an area they can legally work on.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
Laura
Posts: 110
Joined: Sun Jul 17, 2011 9:19 pm
Location: Astoria, Oregon

Re: Question

Post by Laura »

Thanks ladies for all the information and great advise I really appreciate your input. :D

Laura
paulette
Posts: 184
Joined: Sun Sep 19, 2010 6:13 pm

Re: Question

Post by paulette »

Laura,
The place you describe as the point of pain sounds like the place where my pain was located. Dr. Conway told me it was referred pain from the point where I was entrapped. The point of entrapment was actually higher.
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