Health Organization for Pudendal Education

I have a lot of central sensitization along with my PN. Some doctors say it's fibromyalgia, but I don't think it's really fibro. Anyways, I wonder those of you who take muscle relaxants or medicines in the evening to help with sleep/muscle fatigue what do you take or what do you think works the best?

I have tried tricyclics (i.e. amitriptyline, desipramine), flexeril, ativan, bacolfen/valium suppositories. Some nights I sleep really well with my normal 800mg Neurontin dose at bedtime, but sometimes I wake up several times throughout the night and feel like I was hit by a truck when I woke up, every muscle in my body would work. I've been taking Ativan occasionally 0.5mg for pain and it helps a little, but I noticed when I took it at night I think I did sleep better and woke up more rested. I've been thinking about trying to get on bacolfen PO throughout the day as it is longer-lasting than Valium to help with some of my muscle issues. Any thoughts? Seems like my 2400mg Neurontin just isn't cutting it anymore (i wonder if one can build up a tolerance to it). I don't do well with Narcotics or Tramadol.

Hi Faith,
Would you be willing to try gentle massage to loosen up your muscles? I'm not suggesting "myofacial release" by a PT and I do NOT recommend any type of massage in your pelvic area. I tried all of the meds you listed (and then some) with no success. You may also want to consider that your muscles won't relax because of the excruiating nerve pain you're experiencing. It seems some doctors like to throw the "fibro" diagnosis at you when they don't know/understand what's really wrong with you. I don't think you have it, either. IMO, I think it's possible that your muscles are severly clenched by a specific response to the nerve pain. Your body is trying to protect itself. Until that underlying cause is addressed and removed, I don't see how the muscular component can improve a great deal.

When I realized how well valium worked for me, I tried the muscle relaxer Soma because the PA who does my meds told me that as a muscle relaxer it is much stronger than valium. However, although the Soma is a stronger muscle relaxant, it was not as effective for me as the valium. It couldn't hurt to try, but You might want to try oral valium seperately and compare efficacy vs. side effects, valium vs. muscle relaxer. I had more sedation with the Soma; the sedation from valium was very temporary and then I adjusted to it and feel normal even when I take a relatively high dose on "flare days". The adult dose of valium is up to 25mg daily, so if you are on less, you might want to work on weaning yourself up to a higher dose and see if it benefits you more than a muscle relaxer would.

A pain management doctor told me the muscle relaxer Zanaflex also has a small effect on the central nervous system and thus an analgesic effect also. It's a fabulous muscle relaxer for me, but I could only take it at night because it knocked me out.

Lauren

When Valium helps us, as it does myself, one tends to think that the muscle tension in the pelvic floor is causing all of our issues. i.e. that the nerve is being compressed by muscles that are in spasm. I know that does not seem to correlate with surgical findings, but it is interesting that Valium helps so many of us with nerve "entrapments".

cari

carolynm wrote:When Valium helps us, as it does myself, one tends to think that the muscle tension in the pelvic floor is causing all of our issues. i.e. that the nerve is being compressed by muscles that are in spasm. I know that does not seem to correlate with surgical findings, but it is interesting that Valium helps so many of us with nerve "entrapments".

cari

Valium also has an effect on the central nervous system, I'm not sure if anyone really understands its role in pain control. But I do know that I felt better for about a week after getting an impar ganglion block, which the Doc told me means that my autonomic nervous system is involved in my pain syndrome. The autonomic nervous system is also involved in anxiety disorders, which is what valium was originally designed to treat. I really don't know what valium does centrally, but I know abrupt withdrawl (vs. weaning) after prolonged use of a high dose can lead to a withdrawl syndrome which might include seizures. So, it is definitely a centrally active drug, and only a very mild muscle relaxer.