His and Her Health

Hi

I have been seeing a pt for PFD and although my muscles feel like they may be getting slightly looser, I am still experiencing the burning pain at the vestibule, when anything touches it. I was told this is all part of PFD. If so, why is this area not getting any better? I have been seeing a pt now for close to 2 months? Can anyone answer please

It usually takes longer for the nerve sensitivity to calm down, even after the muscles have loosened. But there are a couple questions...have you always had pain at the vestibule? Are you taking birth control? do you have any other symptoms, b/c all of these can affect the vestibule pain.

Amy

Thank you for responding to my question. No I have not always had pain at the vestibule and I am not taking birth control. I just pressed the lower part of my vestibule (where the docs normally do the q-tip test) to see if pt was helping that area at all and omg I literally thought I was going to die today. It was this intense burning pain that would not let up. Fortunately, I had tramadol and lorazapam which I took both. I felt like taking the whole bottle!
Is this muscular- or should I be doing more than pt. Life is just not worth living like this

p.s I notice as soon as the burning starts at the vestibule shortly after it seems to spiral into rectal pain too. Such a mess:(

My doctor and pt both told me that the PFD is causing the pain at the vestibule. Can someone please tell me what occurs exactly. What nerve is that?

thank you

smb456,
Are you on a "densitization" program such as using dilators and massaging the area on your own? These techniques are usual in allowing the area to remember that touch is ok and when there is touch the area does not need to flare up. Again, it will not happen over night and I know 2 months seems like forever in treatment, but i would say on average most go through 3-6 months of treatment (+/-).

Everytime I touch that area, I spend atleast 24 hours feeling like I have a inferno there. What causes that horrible burning at the lower part of the vestibule if this is PFD. Can you please explain the process so I can better understand.

thank you

are you icing?

yes Niva, I do use Ice it helps just a little. What is Vulvar Vestibulitis and how do you know if you are dealing with that ( too many nerve endings) or PFD which is causing the pain at the vestibule.

I read certain things that a person with VVS should do, meds, capsaicin, lidocaine, my doc just told me to do PT how do I know he is right? that I shouldn't be doing these other things?

Here is a link to an article on our website that may explain vulvar vestibulitis.
http://www.ourgyn.com/content/index.php?option=com_content&task=view&id=149&Itemid=84

you can probably do more than just PFD, lidocaine could help you in the worst moments to ease he pain for about 30 minutes...

I would suggest you get a second opinion from a different doctor.

smb456, if what you are pursuing currently is not working for you, I agree with suffering, get a second opinion. I can't tell you what you need to be prescribed as it is not in the scope of the PT to prescribe or tell a patient to take a medication. I did mention a few meds on another question you posted though.

I started Lyrica and it seems to be helping the vestibule pain, if a nerve pain med helps should I automatically think that I fall into the nerve proliferation category rather than the pelvic floor dysfunction category and how can you tell?

no, bc it can be a combo of both!

so when do you know if you need a vestibulectomy?
I have been in pt for 2 months, the vestibule pain just got better since I started the lyrica, so does that not indicate more of a nerve issue- when do you consider a vestibulectomy? Because can't nerves firing in that area, cause the muscles to spasm?