Health Organization for Pudendal Education

Hi!
Have waited for a consultation with an orthopedic&spine surgeon before writing here.
Neuropathy due to compression/blow (two lumbar/sacral disk bulges - heard a sharp "crack" and collapsed on the floor - and a dislocated/misshapen coccyx almost 90% angle). Two doctors examined me (one probably an assistant/student) and had a discussion (argument) about the coccyx (broken/dislocated when fell or born like that). The professor dismissed the coccyx with his hand but the assistant mentioned it in his written summary.

Must have an EMG of the legs and consult with a neurologist.

"Difficult to treat, easier to treat a broken leg...". Only treatment: medications - Cymbalta and Lyrica (together???). Allowed to continue Percocet 10 (1/4 pill every time). How is it possible to take so much medication???

Started Cymbalta 30 mg last night ( 1 per day for a week). Am not feeling well at all: slightly dizzy, slightly nauseous, strange. Will not last long like this. My GP refused to give me Lyrica instead of Cymbalta or both together (would not have taken them anyway).

Have consulted about Apostherapy and will probably try it because a friend of mine said it is a little like Pilates and might help with the pain/burning/tingling between my legs. The physiotherapist was not so sure about this treatment but said I had probably broken my coccyx (cause of pain when sitting) the day I fell three times. He said doctors don't like to write things down in documents (especially when they have no treatment for the coccyx?).

Feel lost, confused and quite scared. Why didn't anyone send me for an EMG and to a neurologist before? It's been 4 years...

Grateful for any comments, reactions, ideas...

Mia

Mia, a lot of people can't tolerate starting out with that high of a dose of cymbalta. Maybe they could start start you out on a lower dose and you could work up.

Violet

Hi Violet,
Thanks for replying.
Nobody mentioned a dose lower than Cymbalta 30 mg. Is there a lower dose?
Anyway, am not at all sure about this whole treatment. Nobody seems to be sure of what they are doing...I feel part of an experiment.
Thanks,
Mia

Mia, when I began with Cymbalta, I was on 20 mg. I don't know if that is the lowest or not. Many meds can be put in a liquid form at a pharmacy (at the doctor's request) and that can help you start even lower because you can measure whatever dose your doctor prescribes.

Hi Stephanies,

Thanks for the info. Am seeing a doctor tomorrow about a lower dose of Cymbalta (or giving up altogether...).

What is the point of taking Cymbalta? I still take Percocet 10 and am scared of the mixture.

Why did you write your pain returned 12/13?

All the best,

Mia

Hi There

There is one thing i will say is , the dislocated coccyx is A VERY VERY IMPOTANT PART of what is creating PN and pelvic pain etc as you have pelvic muscles and ligaments that attach eg. your ST and SS ligaments have a partial attachment to the coccyx , now the Pudendal nerve goes between the 2 , they are pulled tighter because your coccyx goes to one side , it compresses the nerve , and also puts your pelvis out of balance which will create pain .

Now for the Professor who dismissed the coccyx i would have GREAT CONCERN . GET A SECOND OPOIN , it sounds like the student was correct in having a concern with your coccyx .
Now there can be treatments for the coccyx the trick will be to find someone ,try coccyx.org
The treatment will probably be a internal adjustment with other work as well , fibrous tissue could be a issue .
Aussie-m

Hi,

Yes I also agree the coccyx should be considered an important part of pudendal type pain. Last night I noticed when emptying my bladder i had to strain(a big no no but I wanted to be completely empty). Immediately when this happened I could feel a shooting pain in my tailbone in response to the pressure.

Based on this I am going to get my coccyx further evaluated. Not sure who will be best for this but I will mention it to my pain specialist when I see him at the Sunshine Coast in a few weeks.

Hi!

Thanks to all who have reacted and commented - appreciate and learn from all.

Stopped taking Cymbalta (with GP's approval). Willing to try Lyrica but have not received OK - yet.

Yes, looking back 4 years I remember perfectly well the unbearable, piercing, deep pain in the lower back when I fell. Probably was breaking and dislocating the coccyx.

Have a CT and MRI that NO doctor has been willing to look at (wanted to see whether the coccyx appeared). My GP refused: "it might damage the computer"(?!).

Will take everything to the Pain Clinic at the hospital and will insist in looking at all tests.

In the meantime am managing with Percocet 10 (1/4 pill every 4 hours +-). Hope am not becoming addicted!

Maybe should have undergone nucleoplasty 4 years ago? Read that this technique has not been proven efficient if too much time has elapsed since the initial trauma.

What do I know?

All best to you all,

Mia

Hi there

Have you tried PT , As i said go to coccyx.org , have a look at how to Get a dynamic x-ray of your coccyx to see what is happening try a a GOOD PT [need to find one first ]

I also found a article on PT
http://www.pelvicpainrehab.com/pelvic-p ... eating-pn/
It is by Stephanie Prendergast i believe she is a pudendal PT specialist
what i found was great was the length of the initial consultation being 4 hrs , a lot of PT's don't do a lengthy evaluation .
here is a clip of the article

Appointment Day

A PT needs to take a detailed history to understand how patients developed their symptoms, and then undertake an initial evaluation. In the cases of severe, chronic presentations the evaluation may take up to four hours (or four one hour appointments).

During the initial evaluation, the physical therapist needs to evaluate all of the following:

1.Connective tissue of the trunk, bony pelvis, and lower extremities
2.Pelvic girdle muscles
3.Pelvic floor muscles
4.Lumbo-pelvic and hip joints
5.Peripheral nerves (sciatic, pudendal, posterior femoral cutanoues, etc.) need to be palpated for Tinel’s sign
6.Sensitivity of the central nervous system
Following the evaluation, the therapist should be able to develop a reasonable assessment for the patient as to which impairments are causing which symptoms and how their pain kicked off in the first place

cheers

Hi Pafen
Great that you are having your coccyx evaluated , as i said get a dynamic x-ray , you will have copy this from coccyx.org and ask your specialist and take this procedure to the x-ray place as they will not have a idea . You want the best info ,to get the best treatment .

cheers