Guest guest Posted January 18, 2008 Report Share Posted January 18, 2008 Thanks for the info Chelle:) CStart the year off right. Easy ways to stay in shape in the new year. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 18, 2008 Report Share Posted January 18, 2008 Carolyn, this was sent to me by someone who has had PNE, it came from a PN group. Hope it helps with your question...Hugs, Chelle “PN vs. PNE would mean you are asking how to tell if you have pudendal neuralgia caused by pudendal nerve entrapment (PNE) or if you have pudendal neuralgia (PN) from some other cause. There is a lot of debate on that subject with some doctors saying you can’t know for sure unless you have surgery, some say you can tell from the EMG tests or an MRN, and some say there is no such thing as PNE. In other words, the medical community is all over the map on this. That’s why I think you should start with the most conservative, least invasive therapies first and only go to surgery if nothing else works. I believe PNE does exist because too many people have been immensely helped by nerve release surgery. But it’s hard to make a 100% accurate diagnosis before surgery. You also asked how to tell if it’s the pudendal nerve or not. There are several diagnostic tools to help narrow it down to that nerve. 1. If your pain is in the distribution area innervated by the pudendal nerve that should make you suspicious. However there are other structures in the area too such as muscles that can either be the primary culprit or start to spasm in response to the PN pain. Or there can be other nerves involved or crosstalk between the nerves. Pressing along the course of the nerve is only one small tool in making the diagnosis 2. Diagnostic tests like the EMG or PNMLT that show the nerve is not conducting properly. 3. MRN that sometimes shows inflammation of the nerve but is not 100% accurate because nerves are so small and difficult to see. 4. Pudendal nerve blocks. If you have an effective block that numbs the area innervated by the PN and a good portion of your pain is taken away that’s a good sign it’s the PN. 5. If you respond well to physical therapy, trigger point injections, or Botox into pelvic floor muscles, this may be a sign that the muscles are the primary pain generator.” Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2008 Report Share Posted January 19, 2008 MRN is not available in all areas of the country at this time. The place closest to me that offers it is in PA and that's too far for me to go. There's another nerve test that can be done that I'm sure might pick up if problems occur. It's called a Nerve Conduction Study which is different than EMG. Nerve Conduction study is where they apply to the surface. With EMG a needle goes in to the muscle to do the test to see how the muscle works. Damage to other nerves like the genitofemoral can create a lot of pain (if you can feel the sensation in that area because as Dr. Conway told me sometimes not feeling pain in the nerves can mean that they are damaged) making it seem like it's the pudenal nerve when it's not. That's why I'm going to be interested to see if taking the MRI with the sit up position shows something different than doing it in the traditional position of lying down. Will let you know what happens. Kristy ________________________________________________________________________________\ ____ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2008 Report Share Posted January 19, 2008 Hi Kristy, I'm not sure what you mean about damaging the nerves can cause pain to other nerves...can you explain a little more? I'm curious as to why Dr. Conway didn't mention this to me....? The pelvic/rectal exam didn't hurt me at all, nor does PT...i'm really hoping that doesn't mean that my nerve is damaged so i don't feel the pain there (except my clitoral pain).....? Does anyone know if Dr. believes in PN? I asked her receptionist if she deals with it and she said yes, but i hope she's not one of those who doesn't really believe it or doesn't know anything about it. But then again, I think Dr. Conway said they work with patients together, so maybe she does. ________________________________________________________________________________\ ____ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2008 Report Share Posted January 19, 2008 , Dr. Conway told me that sometimes if you don't feel pain it can mean that the nerves are damaged after I told him that with some of the areas that when touched I didn't feel any pain in that area and I was told, " Well, that's a good thing " by one of the people I saw. As for the other nerves, sometimes when one area of nerves is damaged like I feel is going on with my genitofemoral, ilioinguinal nerves and maybe iliohypogastric nerve the pain can radiate to other nerves which is what I feel happened with my pudenal nerve which would explain why the block that was tried in that area by my Pain Management doctor didn't work. Also, with nerve issues, PT won't help it because PT is more for muscles. It's one of many reasons why I will never consider PT but if I do because muscle spasm becomes an issue on a regular basis (finally felt them spasm here not too long ago due to stress issues but then relax) it will have to be done externally only. As for the receptionist, she was not in a position to give you the information she did. She went out of the boundaries for her job description. I would recommend checking with Dr. 's nurse directly to see what she says. I do know though that in her book Dr. does talk about pudenal issues. Kristy ________________________________________________________________________________\ ____ Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. http://mobile.yahoo.com/;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2008 Report Share Posted January 19, 2008 Did Dr Conway say what he thinks causes Pudendal Neuralgia? Is it the same things that cause entrapment? CarolStart the year off right. Easy ways to stay in shape in the new year. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2008 Report Share Posted January 20, 2008 thanks , Im just trying to figure out what I have/had. Last year the pain was horrific, terrible burning pain which traveled the area of the pudendal nerve. This year thank God its about 90 percent better. I still have occasional burning upon urination and periodically I get these "electrical shocks" up my vagina and anus that are fleeting in nature. The whole thing is really quite odd. Just trying to figure it all out, but just fortunate that the symptoms are getting better rather than worse. thanks! CarolStart the year off right. Easy ways to stay in shape in the new year. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2008 Report Share Posted January 20, 2008 Kristy, Thanks for your info. The referred pain makes sense now. I think Dr. Q is starting to think about other nerves than the pudendal nerve but he didn't mention it was because of referred pain, he thinks that another nerve that supplies the clitoral area might be the problem. Maybe he means the same thing....not really sure. He is supposed to be sending Dr. my records and the diagnosis/referral letter, so hopefully I will get in with her soon. I really want her to check everything out and just for my own peace of mind i want her to rule out something like a skin disorder that maybe is starting there or something like a cyst or whatnot like my pt was telling me a story about. And I am going to look more into the MRN I think just to have another option. ________________________________________________________________________________\ ____ Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. http://mobile.yahoo.com/;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2008 Report Share Posted January 20, 2008 Entrapment is when the nerve is compressed by something like a ligament, thus producing pain from the irritation and compression causing a delay in the nerve signals. Pudendal neuralgia can be caused by this or something else like injury to the nerve from say like a fall, or also from an up-regulation or irritation of the nerves from anything really. Just as vulvodynia really just means vulvar pain, pudendal neuralgia really just means pain in the pudendal nerve. ________________________________________________________________________________\ ____ Looking for last minute shopping deals? Find them fast with Yahoo! Search. http://tools.search.yahoo.com/newsearch/category.php?category=shopping Quote Link to comment Share on other sites More sharing options...
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