Health Organization for Pudendal Education

I finally found someone in my town who may do these nerve blocks. I called them and they said they do them and the website says does them. Strange that I have three doctors searching for someone to do a nerve block and here is someone right here in charlotte that no one knew about. Its one of those pain management places that does injections so I hope he had done them before. The last guy I went to had never done one but offered to read up about it and I would be his first pudendal block. I declined. Any questions I should ask this place about the block before letting them do it?

http://www.amarapain.com/treatments/pain-treatments/

You could ask how many PN blocks they have done so you know they are experienced. You can also ask what the risks are and what you should expect. You can ask what the value of the block is and whether they are doing it for diagnositc purposes. You can also look up their license to see if there are any complaints on record against their license. You can ask what kind of imaging they use and whether their is radiation associated with it.

Violet

So I got this appointment on Feb 11 to see about getting a pn nerve block. But now I am reading the nerve block can cause a flare up. Well I cant really stand another flare up right now so I am wondering if I should wait on this potential block. I will be getting the block with Dellon April 2 hopefully, so why do one now? I thought I had read that the blocks help the pain. That some doctors give a series of nerve blocks as treatment and that they can help the pain, not hurt it. I was just reading about another poster in Egypt who is getting better with the blocks. So does it just vary with the person or maybe the doctor doing the blocks. I just dont know whether I should get one now....if there is any possibility of getting worse then I need to pass on it. I cant take anymore pain.

Hi Robin,

Blocks have both a steroid and a numbing agent, and I think the steroid is the main source of the flare for those who get flares (I did), so you could get the injection with just the numbing agent and use it only as a diagnostic tool. There could still be a flare from the numbing agent, but my guess is that it would be less than if the steroid is in there. The steroid is supposed to give you longer term relief (a few months), but many people do get flares and many do not get any relief (I didn't). My pain doctor said that one of his pn patients gets relief from the steroid, and I remember Dr. Hibner saying in 2016 that one of his patients flies to Pheonix a couple of times a year to get a block because she got several months of relief from them. So, some people do get relief, but my guess is that that it is the minority. The poster from Egypt---I assume you're referring to Lelej---is not getting a steroid in her injection. I asked her that, and she said it doesn't have a steroid. It is important, as Violet noted, that the doctor have imaging and have experiencing getting to the pudendal nerve, so that you can be sure s/he hit it. If you don't have a reduction in pain, you don't want to worry that it's because the doctor didn't hit the nerve.

April

Thanks for your reply april. So I had a cortisone shot into the general area of the ischial tuberosity and it took away the pain for 3 or 4 days and then the pain was reduced maybe 20% for two weeks, then the pain came back with a vengence, way worse than before. So I understand getting a flare from the steroid.

But I thought nerve blocks were just lidocaine. Didnt realize they put cortisone into them also. I will ask the doctor whats in it. I think Dellon just uses lidocaine or some numbing agent in his blocks. At least thats what he did with me years ago when I saw him for my leg. I dont like cortizone, I have problem sleeping after it and it definetly flares my nerve.

Hi there! What is your pain level from a 1 to 10? Is it a consistent pain? I ask because I had a nerve block last week with just lidocaine and I am in a worse place now and trying to get back to where I was before. I know the doctor did the nerve block right through ultrasound and my nerve was not hit. If your pain level in my opinion is five or higher on a consistent basis then I would consider doing a block. But if it is less then i wouldn’t.

My pain seems to start ok in the morning, just pain level of 2-4 but it goes to 6-7 in afternoon, evening. I never know what to say when they ask me for a number. One doctor said 10 was being boiled alive in acid. So I never say 9 or 10. I cant believe how its gotten so much worse in such a short time. I mean back in October I could still drive some and go out to eat, but now the pain is doubled or tripled...I just dont know how to measure it. At first it was only the sitting now its there all the time and sitting is impossible except for a just a few minutes at dinner. So the nerve block made you worse? I think I must have one to have a proper diagnosis pursuant to the Nantes criteria. But will never take another steroid shot....after it wore off pain just went way up, to new levels and and has stayed there

Hi Robin,

That's right--I'm remembering now that you did have a steroid block already. Blocks normally have both in them, but you can get them with just the numbing agent. Your appointment was today, right? Did you request just the numbing agent? And did it reduce your pain for a while? I'm so sorry about your pain. The increase in pain as the day goes on is common with this problem. You should be able to increase your pain medication if you are in that much pain. You have a pain doctor, right? If not, I would get one as soon as you can. I agree with you that it's hard to use that 1-10 scale. I think I under-reported my pain too, but you should not do that. Sometimes explaining what you would give up to make the pain go away permanently (for me it was leg) helps convey it.

April

I like to use the comparative pain scale. http://www.pudendalhope.info/node/18

Violet

That scale is great, Violet!

April