Health Organization for Pudendal Education

Hi,

Does anyone have a theory as to why walking spikes the pain so much?

I can move about pretty well throughout the day no worse for the wear if I avoid squatting, lifting...etc.....but if I take an extended walk (which really helps my depression), my pain levels go way up for the following week.

I'm thinking it could be the constant friction to an entrapped area?

Love to hear ANY theories.

Wishing you all less pain.

Jackie OUCH

I have a one-word answer: HIPS! Have you had an MRI of your hips? I think there is a strong co-relation between bad hips and chronic pelvic pain and PN. (Sorry folks for sounding like a broken record.)

I am recovering from recent arthroscopic surgery to repair one bad hip and will likely need surgery to repair the other. Both Surfsup and MNMom have also had both hips arthroscopically repaired.

I'm sorry to hear about your pain with walking. It sounds so familiar to me!

Hi Jackie Ouch,
I had mega pelvic floor tension for the first 2 yrs after my injury and couldn't pinpoint one specific source of pain from another. Everything just blurred together like a big ole hornet's nest. When that tension eased somewhat several months ago but I noticed an increase of pain even a short walk.
Wishing you less pain too!!
FG

Thanks so much for your replies.

Excellent point about the hips, but I've had numerous hip studies (MRI, CT SCAN...etc...) and my hips are fine.

It feels like soft tissue and nerve to me, not a bone on bone issue.

I can get the pain to settle down to a reasonable level and then one long walk and my pain spikes like crazy.

(By the way.....a hot bath will do the same thing......Obviously the sensory part of the nerve is haywire).

I'm thinking that the constant movement of walking is causing friction to the nerve in some way?

Does this make any sense to anyone?

Would this indicate where I might be entrapped?

The other Pudendal nerve aggravators will increase my pain too....but at least I used to be able to take a long walk.

Best,
Jackie

When did you last have your hips imaged? Apparently labral tears have only been detectable by MRIs within the last five years. My hip pain started ten years ago, at which time a musculoskeletal workup was negative. I only discovered my FAI and labral tears in a new MRI taken last summer (following a tip on this forum).

FYI, here's another thread on walking pain. I started it last year before discovering that I had pathology in my hips. Now it's all making sense to me!

http://www.pudendalhope.org/forum/viewt ... le+walking

Walking stirs up all my pn symptoms too. Thanks for the link Lernica, I saw that sacral pain is very common for many on this website. This has been a very bad area for me from the get go and has worsened considerably.
All the best, FG

Another thing to consider is piriformis or deep gluteal syndrome for walking difficulties. It can cause sciatica, pudendal as well as post femoral cutaneous nerve issues too. If that muscle is very tight it can drag the hips and groin into the pain equation even if the nerves are not involved in that particular area http://www.pudendalhope.org/sites/defau ... 357_01.jpg.
There is the theory of 'nerve cross talk' of course . While I don't doubt that it can occur (I may even have some of that damned chatter myself) I think it is sometimes too easy a diagnosis for what could be other underlying issues.
It's a new year and I haven't even mentioned fit flops once yet so here goes. http://www.soleprovisionsshop.com/FitFl ... e_s/41.htm (USA stockist) These shoes are quite honestly my saving grace. I can NOT wear any others.I think that skechers do similar ones but haven't tried them as I am so happy with my ever growing collection of Fit Flops. The 'Othraheel' shoes looked interesting on that sole traders site too, says they do a 30 day trial. might be worth following up?? http://www.soleprovisionsshop.com/Articles.asp?ID=153 s
They do have sneaker style shoes, clogs and boots as well as flip flop styles btw.
If anyone has hip or other walking difficulties, I can't recommend them highly enough. They are a good shock absorber as the soles are very spongy but offer necessary support too. I couldn't give a stuff about the 'work out while you walk' part, they just help me WALK!! : . . . . but does my bum look big in this?

Jackie-O!!!!!
Sorry you're still having problems, but it's sooooo nice to hear from you again! I remember you from the other pudendal site.
Before I contribute suggestions about why you experience pain after going for walks, WHERE are you feeling the pain? Do you feel pain while you're walking, or does it only come on afterwards?
Looking forward to hearing from you again ...
Hugs,
Karyn

Karyn!!

Thanks for remembering me.
It's been a long time....had to take a break from reading all this suffering....my head was spinning.
I feel pretty good walking for the first half hour (if I haven't walked in a few weeks), then the pain really starts to kick in. The worst of it is immediately after, and the next morning is awful....lasts for about a week.
Pain is primarily DEEP in the right obturator/labial region....feels like someone hit me with an axe and left it hanging there....lol...and my legs become very restless and overactive...lots of burning....hamstrings are in knots....the sciatic nerve kicks in too....but the right obturator/labial region is the worst.

Helenlegs

I do believe you are right on target. I think the piriformis is a huge issue in my particular case. As the MRN showed it is enlarged on the right side. Also, if I do piriformis stretches, I'm in BIG trouble.
And SHOES are a huge issue too!
I HAVE to wear cushioned shock absorbing shoes at all times, with my feet in a neutral position at all times....the wrong footwear will set me off IMMEDIATELY. I do wear prescription insoles while walking.

When Dr. Hibner did the physical exam, he just examined me internally, and I just have a sore feeling....He thought if it was classic PN I would have been screaming in pain...What do you think?

So, if the piriformis is the main culprit, and stretches make me worse......Is surgery an option in that area? Does PN surgery even involve this area? Injections? Do you think the Potter MRI is worth a try?


Maybe I should just keep living my extremely limited lifestyle and leave well enough alone....

XOXOXOX for helping me try and figure this out.

Jackie

Hi Jackie,
Thanks for the explanation. Well, hon .... it could be your obturator nerve or the perineal branches of the PN. Sounds like something's not gliding when you walk, hence the severe nerve irritation. Have you ever had obturator or PN blocks? Please forgive my bad memory
Helens input about the piriformis and your sciatic nerve is spot on (as usual!). Have you persued any treatment for that? Sounds like you've got a lot going on here, luv. I don't know for sure, but I don't think the main culprit is the piriformis/sciatic or the PN. It's possible to have BOTH and other neuropathies as well.
I do think you may benefit from an MRI read by Dr. Potter. I hear she's booking out to July now.
XOXOXO - Right back atcha!