His and Her Health

I am a 62 year old female and have dealt with pelvic pain which came on suddenly 5 and 1/2 years ago and quickly became a chronic pain issue. I also began to have neurological symptons (pain and tingling throughout my entire body) in addition to the pelvic pain. I have been to a urologist, gynecologist, gyno/pelvic pain specialist, had physical therapy - kegals, TENS unit - EMG readings which once showed 40% excessive activity in pelvic area, then years later, no unusual activity reading; a chiropractor, neurologist -- all referred to by my primary gynecologist (with the exception of the chiropractor - which I sought on my own. Xrays of spine here revealed a tilted pelvis. I've been going for adj. every two weeks to spine for 6 mos. to correct the tilt in pelvis. Am holding adjustments well. No relief in my pelvic pain from adjustments).

The neurologist said I had very overactive tendon reflexes, but no explanation as to why. I also have what seems to be hot flashes all through the day - I think this is coming from the tingling sensations, also. My lower pelvic area seems to be in constant tight spasms along with the pain.

I returned to my gynecologist recently for help again with my pain, after trying the other referrals he had sent me to. I've had numerous medications, pelvic trigger point injections of marcaine, cat scan of brain and spine and MRI of brain, ultrasounds of pelvis and urinary tract. No meds have helped much with the the pelvic pain or the tingling throughout my body. The only ones that seemed to help any were 3600 mg. neurontin and 60 mg. cymbalta, which eventually got to where they were not effective.

My gynecologist now thinks I have vestibulitis along with perhaps some type of neurological problem - doesn't know if the two are connected. With the cotton swab test recently I had pain in four spots around my clitoris. Two sets of lidocaine injections in the doctor's office on the four spots did not provide much relief. We are now trying lyrica 50 mg. x 3 times a day. Vestibulectomy may be an option he said somewhere in the distant future, but he wants to make sure this is what is going on first.

I noticed no one on this forum has mentioned having spasms in the pelvic area or any pain when sitting. Any pressure on the pelvic area when I am seated increases my pain level. By night time, the pain level goes up several notches. I do secretarial work and am seated at work most of the time. I am in pain while standing, but not as severe as when I am seated. Anyone else experiencing this? Please respond. Also, any ideas Dr. Goldstein? I am in pain 24/7 and have never been sick in my life until this came along.

Would this be pudenal nerve entrapment? On the happy pelvis yahoo group, there are women with pelvic issue who too cannot sit. Some remark that they even check their email standing up. I don't know much about it, but maybe you can check it out.

Chronic pain is not an indication for vestibulectomy. Have you tried intra-levator BOTOX injections.

Jam, I have no idea how I copied your message; I was only wanting to reply to it. My situation is very similar to your's; I've had pelvic pain for approx. 7 years. The minute I sit down, I start hurting in the pelvic area -- a spasm and and also a strong pulling sensation. My last visit to a dr. was on Friday to an orthopedic surgeon - was sent to him for evaluation for a complete hip replacement because of a labral tear. The dr. said my hip was in good shape -- consulted with 2 other drs. during my visit. He wants me to consult with a labral tear specialist (did that approx. 3 yrs. ago) but he said it was possible that my pain was coming from my spine.

I hope you have been able to find the cause of your problem and, if so, if you would share that information with me. Do you mind if I e-mail you privately because, as you can see, I didn't do a great job with this one.

Jam, First of all an above reply mentioned Pudendal nerve entrapment. Just bc there is painful sitting DOES NOT qualify as having this issue!
I see many women (and men) with chronic pelvic pain who have difficulty sitting and symptoms are worsened with sitting. I highly suggest an appropriate cushion for work and driving since you are sitting mostly.
Another thing I noticed was the word Kegels. I don't recommend kegels to my patients with acute flares and with muscle spasm. I don't want them to get more tense in this area.
I also have had patients evaluated by neurologist with over active reflexes.
As for bhbrew, I also have patients with diagnosed labrum tears in the hip.
All of your symptoms are legit and common to many of my patients.

niva

<small>[ 12-21-2008, 08:03 PM: Message edited by: Moderator ]</small>