Health Organization for Pudendal Education

Much to my surprise, my Potter MRI showed tendinosis (degeneration NOT inflammation) in these tendons as the main problems. I have typical PN symptoms: cannot sit at all, or bend; pain in the perineum and deeper in; occasional painful spasms of the pelvic floor.

I'm mentioning the tendinosis, as it may be a cause for others.

I hear that tendinosis can be helped (application of a nitroglycerin patch over the area). I haven't tried it yet, but it gives me some hope that this awful disability might improve!

--Christi

Thanks for posting this info Christi. I will be interested to hear how the nitro patch works for you. Good luck!

Violet

Keep me posted! See attached review article of treatment options.

Hi Christi,
My recent potter MRI also showed mild hamstring tendinosis w/o tear. Have you gotten a doc to prescribe the patches? I dont think this is my main issue, but I have constant tight hamstrings, and I stretch them all the time. Do let us know how those patches work.

Hi NYT,
I read your attachment with interest. ESWT was mentioned too, interesting..thank you!

Thank you,
Debbie

Could an overuse injury and tendinosis ever be due to muscle spasms I wonder? I doubt that it could be with larger muscles as the spasm would be extremely debilitating to cause such problems but maybe smaller (pelvic) muscles? They are definitely getting overused if in an almost constant spasm. I know my gluteal muscles have been diagnosed as having 'gross enthesitis'
Enthesitis;
Traumatic disease occurring at the point of attachment of skeletal muscles to bone, where recurring stress causes inflammation and often fibrosis and calcification.
or
Enthesitis (Inflammation Where the Ligaments Attach to the Bone)
Inflammation of the enthesis, where the joint capsules, ligaments or tendons attach to the bone.
It is the process of healing and repair following inflammation of the enthesis that eventually can lead to scarring of the tissues, which subsequently can lead to extra bone formation or calcification.

I know that any time anyone tries acupuncture, dry needling or even my piriformis botox injection the muscles are in such spasm that the needles are very difficult to get in and then more difficult to get out. I just wonder if tendonosis (without inflammation) tendonitis or enthesitis (both with inflammation) could be as a result of muscle spasms. I have only heard of it in relation to arthritis before and I don't have arthritis (except in one thumb)
Just thinking out loud.
Helen

I hope this will help you get some relief!!

I'm curious if the Nitro patches are just to help with symptoms, or can they actual help with healing?

Wishing you relief.

Jackie OUCH

Nitro patches are supposed to actually help heal the tendinosis, acccording to reputable scientific studies. I haven't yet talked to my doc about writing me a prescription so I can try one. I know they tend to cause headaches, so I've been a little reluctant. But I don't know what else to try!

Christi,

I had an anal fissure and was given a Nitro/lidocaine cream to use. It did give me headaches, so I did some research and found that Nifedifine/lidocaine is a great alternative without the side effect of headache. The action is the same. It helps heal by increasing blood flow to the area. It has to be made up by a compounding pharmacy, but it wasn't too expensive.

I wonder if this would be an alternative for you if you have problems with the headaches.

Best,

Jackie OUCH

I didn't know that lidocaine works by bringing blood to the area; I'll have to look that up. I used lidocaine patches for a short while about 18 months ago. I thought they were just for anesthetic purposes. (Didn't help anyway!)

--Christi

Oops, I didn't read your post carefully enough (still groggy this morning!). Of course, Lidocaine is a vasoconstrictor, but Nifedifine is a vasodilator, like Nitro.

Apparently Tiger Woods and high end soccer players favor the nitroglycerine patches for their tendinosis. Perhaps the headache issue wears off after a while...