Dr.Dellon's publication

[ezer]

We discussed Dr.Dellon on the dosrsal nerve thread. I found this interesting paragraph about nerve damage on his site. He specifically discusses carpal tunnel syndrome but it is easy to extrapolate to other nerves:

http://www.dellon.com/ps/ch1.lr.pdf

The research models I helped to develop in the early 1980’s demonstrated that within 2 months of nerve compression, fluid begins to leak from blood vessels into the nerve, that by 6 months of compression, the myelin protein covering the nerve fibers begins to get damaged, and that by one year, nerve fibers have begun to die. Scar tissue forms between the bundles within the large nerve.* The nerve itself,may become stuck to the surrounding ligaments. Once this degree of scar tissue forms, only surgery can relieve pressure on the nerve sufficiently to relieve symptoms.
Surgery must relieve pressure on the compressed nerve. Either the rock or the hard place must be removed, or the nerve itself must be moved to place without a rock or a hard place to compress it.

[pianogal]

this is amazing. thank you for posting. my PT husband always explained my pne as similar to carpal tunnel of the pelvis, but this article explains why some of these things happen beyond what my husband always said, which was that through something simple as repetitive motion can create inflammation which once stuck in a tight canal, cannot uninflame itself. But this article takes it a step beyond, giving a timeline and rationale for degeneration of the nerve.

i wonder if this theory could apply to surgical recovery as well, and if anti-inflammatories should be used more heavily post surgery, as well as supplements to aid in nerve healing.

This link talks about failed carpal tunnel surgeries. Perhaps the same theories can apply to the Pudendal Nerve.
http://www.medschool.lsuhsc.edu/neurosu ... arpal.html

[Karyn]

I really enjoyed reading his paper. Unlike most of what I've read, I found this very easy to understand.
I'm soooooooo upset he doesn't accept insurance!!!!!!!!

[A's Mommy]

Ezer,

Thank you for posting this article of Dellon's. It is very VALIDATING to my recent TG decompression surgery. I NEEDED THAT SURGERY.

[Karyn]

Yes, I agree! It was very validating:

Once this degree of scar tissue forms, only surgery can relieve pressure on the nerve sufficiently to relieve symptoms.
Surgery must relieve pressure on the compressed nerve. Either the rock or the hard place must be removed, or the nerve itself must be moved to place without a rock or a hard place to compress it.

It's nice to see in black and white what I've felt for the past couple of years!

[Griff522]

Thanks for posting this Ezer.

This whole thing about dr's not accepting insurance is not new to me. I've encountered a couple of psychologists that would not file with my insurance. They found it too cumbersome and time consuming. And one psychologist told me "good therapists" don't take insurance because they don't want the insurance company telling them to put their patients on medication.

Anyway, I paid for my services up front and then filed it myself with my insurance company and I was reimbursed for my share of the fee. Wouldn't this be an option for Dr. Dellon as well?

[Charlie]

my PT husband always explained my pne as similar to carpal tunnel of the pelvis,

I know a PT who also explains PNE similar to Carpel Tunnel syndrome.

I notice this sentance in the article

She had an area of skin that felt unusual when touched (the dotted area) and a trigger point that sent the pain downwards towards that unhappy (dysesthetic) skin. This meant Carmen had a neuroma of a nerve to the skin.''

So what presents as a 'trigger point' is actually a nerve problem in this case a neuroma. Interesting.

I know others have quoted this but I also completely agree with it.

Once this degree of scar tissue forms, only surgery can relieve pressure on the nerve sufficiently to relieve symptoms.
Surgery must relieve pressure on the compressed nerve. Either the rock or the hard place must be removed, or the nerve itself must be moved to place without a rock or a hard place to compress it.

The sad thing is I expect many patient persevere with physical therapy when they really have an entrapment, as I did. I notice Dellon does not even list myofascial PT as a conservative measure to try before any of his surgeries.

[Charlie]

Another paper by Dellon

http://www.ncbi.nlm.nih.gov/pubmed/16286101

CONCLUSIONS: The pudendal nerve is susceptible to compression at the passage from the Alcock canal to the dorsum of the penis. Individuals exposed to repetitive mechanical irritation in this region are especially endangered.

[Cora]

thanks for this thread - a lot to chew on.
Cora