Surgical/injury causes v "unknown" causes

Many physical activites such as sports, pelvic surgery, etc can all contribute to PN
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Grace
Posts: 56
Joined: Wed May 08, 2013 4:18 am

Surgical/injury causes v "unknown" causes

Post by Grace »

From what I've been reading across the HOPE board, it seems that for surgical/injury causes of PN/PNE, recovery or partial recovery (high function with rigorous management) is more likely than for cases with "unknown" causes of onset.

Does anyone know of studies that consider this question?
Anal/rectal pain began 12/12 | Pain advanced to entire pelvis by 2/13 |
PF PT 2/13 to 7/13 |Acupuncture 7/13 to present
Pain is CONSTANT, made worse by standing, walking, kneeling
UNBEARABLE with sitting |Cushions mock me
20+ years of fibromyalgia | Interested in not losing my marbles...
My goal: To find creative ways to live and work with PN, while pursuing wellness.
nyt
Posts: 1165
Joined: Sun Oct 31, 2010 3:24 am

Re: Surgical/injury causes v "unknown" causes

Post by nyt »

I have not seen such studies. I'm sure some of the PN doctors have some clinical observations that might answer your question.

I do think from my conversations with a couple of the PN doctors that they are more likely to think a true entrapment if one has had surgery such as mesh prolapse or hysterectomy than a spontaneous onset where they are more likely to think the symptoms are caused by something else.

As far as recovery from PN/PNE, to me, it seems all over the board whether there is a known cause or spontaneous onset.
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
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Grace
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Joined: Wed May 08, 2013 4:18 am

Re: Surgical/injury causes v "unknown" causes

Post by Grace »

K. Thanks. Guess it's just a crap shoot anyhoot?
Only on the down days. Trying to stay positive and grateful. I'm not throwing in the towel today. Tomorrow..? Has enough trouble of its own! ;)
JackieOUCH
Posts: 58
Joined: Thu Oct 28, 2010 7:06 pm

Re: Surgical/injury causes v "unknown" causes

Post by JackieOUCH »

Personally, I think it's the "perfect storm scenario" for sufferers without an obvious cause:

1) Anatomical predisposition (long torso or ischial spine causing more tension on the ligaments, narrow nerve tunnels)

2) History of high activity (cycling, sports, weight lifting)

3) An injury (fall that impacts the sacral, tailbone, buttocks area)

4) Inflammatory diseases (endometriosis...etc...)

5) Predisposition to over formation of scar tissue

Please add to the list..........

Let's face it, if it was from sitting too much, EVERYONE would develop this!

Less pain,

Jackie OUCH
Started with severe burning sacral pain to R hip/pelvis, bladder, bowel
History Endometriosis
Antolak Diagnosed PN--1 PN block made pain much worse & more widespread for a year
PT 2 yrs--Did not help physically, but was educational
Potter MRI: Symmetric thickening Sacrotuberous ligaments/scarring ischial & Alcocks canal.
srinmav
Posts: 34
Joined: Wed Nov 17, 2010 6:25 pm
Location: India

Re: Surgical/injury causes v "unknown" causes

Post by srinmav »

JackieOUCH wrote:Personally, I think it's the "perfect storm scenario" for sufferers without an obvious cause:

1) Anatomical predisposition (long torso or ischial spine causing more tension on the ligaments, narrow nerve tunnels)

2) History of high activity (cycling, sports, weight lifting)

3) An injury (fall that impacts the sacral, tailbone, buttocks area)

4) Inflammatory diseases (endometriosis...etc...)

5) Predisposition to over formation of scar tissue

Please add to the list..........

Let's face it, if it was from sitting too much, EVERYONE would develop this!

Less pain,

Jackie OUCH
I think I have many of these factors:

1) I am not sure
2) Yes, I did a lot of cycling and weight lifting when I was young.
3) I had a very nasty fall on my back from a height of about 16 feet at the age of 12. No bones broken but my first pelvic symptoms started approximately three years after this fall. I think this was the fall that caused my cyst, or provoked a small harmless cyst into growth.
4) Yes, I have autoimmune disease.
5) Likely, I am not sure though.

The first major PN like symptoms were triggered in me by excessive sitting. Due to certain major health problems in the 90s, I could no longer lie down in bed and used to sit on a chair and sleep all night - this means I was probably sitting 20 hours a day and several hours continously without change of posture every night. After one year of this ordeal, I started getting the classical PN symptoms in 1995 - unusually excessive sitting for one year had obviously damaged my nerves very badly back then. These symptoms were acute and lasted for two years before mysteriously disappearing. It returned with a vengeance in 2004, again at a period when I was sitting (at work) excessively for like 16 hours every day. But this time the symptoms did not disappear as it did in 1997.

I think if I had been aware at a younger age that I had this cyst, I would not have done all these and I may have been far better off now. For me, unusually excessive sitting was perhaps the single most factor that caused my cyst to go highly symptomatic. And all that sitting were not on suitable or cushioned chairs - they were on hard plastic chairs. No MRI of my spine was taken during the 90s and had the doctors taken me seriously and ordered an MRI back then, at least I would have known that I have a cyst down there and I would have been very careful and probably I would have been in a far better condition now.

Excessive sitting, in conjunction with the nasty fall that either created or triggered a dormant tarlov cyst - are the contributing factors in my case. I also did yoga and lots of stretches and strength building exercises - these were secondary factors. Before the discovery of the cyst in 2006 I thought that the autoimmune disease was the primary cause of my PNE, now I am not sure whether this disease had any major part. ( but tarlov cyst and connective tissue disorders seem to go together, so the connection may still be there)
PN symptoms since 1988. Full blown PN and sciatica since 2004. Diagnosed with sacral arachnoid cyst S1-S4 in 2006.
2008- 2015: Conservative management of symptoms by reduced sitting, avoiding physical strain, meditation etc.
2015-Jun 2019 Bedridden due to pain, wasting and weakness.
Jul 2019- Trying to find my way out. Scheduled for likely sacral cyst and cervical meningocele surgeries in feb 2020.
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