Introducing myself, looking for advice

[Caedar]

You will not need to use the Theracane to massage the pudendal nerve. Take your hand and cup your buttocks, curling the tips of your fingers about 1 inch to the left/right of your anus. Press your fingers in and massage laterally (left to right) until you can feel a linguini-like structure under your fingers. This is your pudendal nerve, if you've done this correctly. Follow it forward toward your perineum (along the "Alcock's canal") until you hit a bony peak. You can also try massaging up and down the nerve once you've found it, but it's harder to do correctly. It's hard to find a good picture, but refer to the white dotted lines here: http://www.rehab.research.va.gov/jour/0 ... il-f05.gif

Be careful. Don't press down so hard that you trap the nerve against the bone. The nerve should not hurt when you massage it at regular pressure. If it feels inflamed (more spaghetti-like than linguini-like) and hurts when massaged, your pudendal nerve is likely irritated.

[Thisismyusername]

Those were really good instructions. I think I found what you are talking about. It does hurt. It's either the nerve or a trigger point that I found. Is there reason to believe that massaging the nerve would be beneficial? If I really found the nerve itself I'm afraid of damaging it.

[Caedar]

Inflammation (which can be generated by pain alone) causes the formation of scar tissue, which can further irritate the nerve as it tries to glide and is restricted (because all nerves glide as you move your body! They're not stuck in place). By gently breaking up scar tissue, you can help the nerve to move naturally again. I was instructed how to do this by my pelvic floor physical therapist, and she told me that as long as you're not pressing so hard against the nerve that you crush it against the bone, you're not at risk of traumatizing it. Just like with trigger points, go to a moderate pain level and stop there. I've noticed that as I've continued to massage my right pudendal nerve, my right-sided penile pain has gone down significantly, and the nerve sensitivity and penile pain have always correlated with each other. No guarantees that it's the only issue in your case, but it might be one piece of the puzzle.

[Thisismyusername]

Good news, over the past few weeks I've had some major improvements. Either the shot kicked in or the initial irritation from the shot wore off and I've had natural improvement. My pain has stayed mostly at the level of 2 (out of 10) or lower and has maxed at 3 for the past few weeks. My pelvic floor feels a lot more relaxed than before. I think physical therapy is definitely paying off. It would at least 2 months to notice any improvements from the 2 to the 3 month mark I have had significant improvements.

I still have pain throughout the day but it is no longer debilitating in the sense of daily functioning. I am starting to feel "normal" again, at least in a sense.

Sexually I still get significant pain on erection and sexual activity increases pain for a while. Real sex is still out of the question. I also still have muscle spasms on erection and hard flaccid most of the day. So there is a long way to go, but I'm finally starting to feel optimistic about things. I'm not sure how close to normal I'll end up but I'm starting to think I can at least live a decent life.

[Thisismyusername]

Well bad news, I've had a major flare up for the past 2 weeks. The pelvic pain and muscle tension has gotten a lot worse. Fortunately the penile pain hasn't increased.

During PT sessions my internal trigger points went from mild pain when pushed on to severe pain when pushed on. I'd say trigger point pain is as bad as it was when I first started PT. This has all been really disappointing and I've started to worry about my future a lot again but I guess I need to look on the bright side. There is hope and there is a good chance things will calm down again. I've certainly learned a lot through this whole process.

[Caedar]

Have you been practising moment-to-moment relaxation and dropping your pelvic floor? That's what will ultimately help you reduce pelvic floor tension in the long-run. The PT is helpful for breaking the cycle, but you will want to get experienced at relaxing your muscles.

[Thisismyusername]

I do feel at times I didn't pay enough attention to relaxing my pelvic muscles. Lately things have fluctuated a lot. Some days have been not bad at all, others have been among the worst days I've had since this whole thing started. Lately my penis has been hurting really badly all over. That is the most distressing part of the pain for me. It feels like painful pins and needles in my whole penis or like my penis has a headache. It feels like someone repeatedly punched me in my dick. Life is rough. Everything else in life is good but this is ruining everything. I need to try to not think that way though. I need to stay strong and there is a decent chance for a significant recovery. I had a taste of major improvement and it can happen again.

[Xams2387]

None of those therapists has had Wise-Anderson Protocol training. I'd advise you to call David Wise ((866) 874-2225 or (707) 874-2225) and ask him for the location of your nearest properly trained therapist.

Is there a database for Wise trained PTs?

[Xams2387]

Did she check your bulbospongiosus or ischiocavernosus? Both of those can refer penile and perineal pain.

When you do this do you just press on those externally ?
Mine are tight and harder up a lot which causes some of my hard flaccid yet everytime I push on them they don't seem to even be tender.

Can anyone help with bulbospongiousus and ischicavernosus treatment?

[webslave]

Is there a database for Wise trained PTs?

Not online, no. Call Dr Wise for recommendations.

[Xams2387]

Gotcha. Thanks.