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Your MRI could be my MRI. :)
I am female, in my late 40's and I got to say that this is probably your Sacroiliac Joints out of alignment, and, the Pendendal nerve being stretched/compressed, either/or, at the ishium bone in the lower buttock. I have had all you've had, plus numbness and foot drop. I have also had glute muscles go numb for weeks and pelvic floor numbness. And it is in your pelvis. Do a search on my name and look for my posts in late Sept and early Oct, where I describe some very easy manauvers to fis the SI joint. They won't kill you and they are mild enough to do even if you have some pain now. I also had the Pendendal nerve problem and just recently figured out where it is hung up and how to get it fixed. I have a long way to go because they've been 'gone' for 9 months.
I have other symptoms to this problem, constipation being one of them, sacrum pain, and also had wobbly, weak legs.


[QUOTE=cguy]So three years later, I think I may have finally figured out what my problem is. I developed numbness in my foot and my sit pain got worse. I just had an MRI of my back and it looks like the first sacral nerve root may be my problem, not PNE. Here's the MRI result. I always thought this problem was in my pelvis somewhere.....

I'm talking to my doc about this....

If anyone has had a similar experience with the first sacral nerve root, please let me know.

Thanks.


MR: LUMBAR SPINE

CLINICAL HISTORY: Sciatica right lower extremity for 3-1/2 weeks.
Rule out herniated disk,

TECHNIQUE: Sagittal Tl spin density and T2 scans obtained of the
Lumbosacral spine. Axial Tl and T2 images cover levels L3 to Sl.

FINDINGS: No comparison.
L1-2, L2-3/ L3-4: Negative.

L4-5: Early disk degeneration. Small central bulge or protrusion
with focal increased T2 signal, consistent with an annular tear. This
slightly effaces the ventral thecal sac though there is no significant
mass effect. The central canal and neural foramina are normal.

L5-S1: Disk degeneration with mild disk bulging. Small broad-based
central disk herniation focally more prominent along the right
Paracentral disk margin, where the disk herniation contacts and
effaces the perineural fats surrounding the proximal right Sl nerve
root, which is mildly displaced. Request correlation regarding right
Sl radiculopathy. While the left Sl nerve root contacts the posterior
border of the disk, there is no mass effect. The neural foramina are
normal. This level is otherwise negative.

The lumbar vertebrae and facets align normally. No compression
fracture or pars defect. The conus appears normal.

IMPRESSION:

1. Mild disk bulging L5-S1 with a small broad-based central disk herniation focally more prominent along the right paracentral margin.
Here, the disk contacts the right Sl nerve root which is mildly displaced and there is obscuration of the perineural fat. Request correlation regarding right Sl radiculopathy.

2. Small central disk bulge or protrusion at L4-5 with an annular tear. No significant mass effect.

3. Otherwise, negative.[/QUOTE]
[QUOTE=sdickins;2873900]Hi Cguy;
I read a few of your posts and am interested in what progress you made in realation to back (sacral nerves?) and pelvic pain. I too have been diagnosed w/PNE but after extensive treatment have seen little improvement. Can you contact me directly to discuss this further? Thxs.
S.D.[/QUOTE]

[B]Hi SD, I am afraid that direct discussion between posters on this forum is not possible. What sort of symptoms have you been having? Pelvic pain is kinda nebulous. There are a number of issues it could be, Sacroiliac Joint Dysfunction for one, Piriformis Syndrome for another, so what problems are you having? [/B]
hello, i have been reading up about pudendal nerve entrapment/si joint dysfunction, and i'm concerned that i may be suffering with the problem. i am living and working on an indian reservation, and access to health care is rather challenging. my symptoms began about 6-7months ago, and they started as pain/burning on the left side of my vulva and pubic bone. i went to see the doctor(s), and they ruled out infection, endometriosis (ultrasound of the uterus and ovaries), bone fracture (xray and bone scan), cysts/tumors (CT scan), and endocrine issues (estridiol, progesterone, fsh). i have been told over and over that nothing is wrong with me, but i still have the discomfort... and it's not always localized to the left labia. it is occasionally in the rectum too (where i feel a full sensation), and i have recently been getting pain in my left butt and down my left leg to the posterior lateral aspect of my knee. i have been to a chiropractor and have had PT, but i'm not convinced that i've found providers who are familiar with this sort of problem. none of the doctors i have seen have asked for a follow up visit, nor have they referred me on to anyone else. i guess i'm wondering if my symptoms are consistent with an si joint problem, piriformus syndrom, or with pudendal nerve entrapment, and if so, where would you recommend i go to get help... what sort of speicalist would be appropriate (i have seen obgyns)? and if there are any specific names you could give me, i'd probably be willing to travel somewhere with better resources. thank you very much!
Hi there. Sounds like you've been through the regular mill of doctors, except an orthopedic doctor. This is who dx'd my Piriformis syndrome, which after looking at it again (I had thought about it and read about it on the web, but I wasn't sure) I knew he hit the nail on the head.

The 'full' feeling in the rectal area, would this possibly be described as feeling sorta numb? Not actually being about to tell when you need to go or even have the muscles functioning? The pain down the back of the leg would probably be the sciatic nerve, which for many people pass through the piriformis muscle. When the muscle gets irritated it spasms and then irritates the sciatic nerve. The nerves of the sacral plexus comes off the sacrum at different levels, and each nerve travels through or next to the muscles of the pelvis and buttocks. Let's say you got a bit silly and tried to pick something up that was really heavy 7 months ago. You got a bit of a sore back, and shortly it got better, but then you had this new problem. It takes a bit of time, only a few weeks, for the body to start trying to avoid pain automatically, and so it starts to shift at the pelvis when you hurt your back. This can then set up a cascade of muscle dysfunction. Even the hips get involved in this. Anyway, the nerve that is being irritated could be compressed or stretched, and this is why you're getting shifting symptoms, because of this action. It can work on particular areas, in varying degrees.

How is your tailbone at this time? Any soreness? Check it carefully, there are little bumps on the bone that are partial attachments for tendons, and there are nerves attached to these tendons and muscles. I found one little bump that when pressed, sent a shot of nerve pain across my butt. I discovered at this time that those little bumps were supposed to be on the sides of the tailbone, not the top of it. So my tailbone was rotated, as was the sacrum. When I worked the one side of the buttock muscles to make these bumps disappear, I started to get the feeling back in the 'saddle' again, and more muscle control.
Get back to me and let me know what correlates with what I'm saying.




[QUOTE=klikar;3040117]hello, i have been reading up about pudendal nerve entrapment/si joint dysfunction, and i'm concerned that i may be suffering with the problem. i am living and working on an indian reservation, and access to health care is rather challenging. my symptoms began about 6-7months ago, and they started as pain/burning on the left side of my vulva and pubic bone. i went to see the doctor(s), and they ruled out infection, endometriosis (ultrasound of the uterus and ovaries), bone fracture (xray and bone scan), cysts/tumors (CT scan), and endocrine issues (estridiol, progesterone, fsh). i have been told over and over that nothing is wrong with me, but i still have the discomfort... and it's not always localized to the left labia. it is occasionally in the rectum too (where i feel a full sensation), and i have recently been getting pain in my left butt and down my left leg to the posterior lateral aspect of my knee. i have been to a chiropractor and have had PT, but i'm not convinced that i've found providers who are familiar with this sort of problem. none of the doctors i have seen have asked for a follow up visit, nor have they referred me on to anyone else. i guess i'm wondering if my symptoms are consistent with an si joint problem, piriformus syndrom, or with pudendal nerve entrapment, and if so, where would you recommend i go to get help... what sort of speicalist would be appropriate (i have seen obgyns)? and if there are any specific names you could give me, i'd probably be willing to travel somewhere with better resources. thank you very much![/QUOTE]
thank you so much for the response... what you said makes a lot of sense. thinking back to when this all started 7 months ago, i do remember doing something that could have set off the cascade you described. and like you said, it was just about two weeks after this event that things started going awry, and the symptoms have just gotten more and more complex. right now, my biggest problem is finding a doctor who's knowlegeable in this area. when i was in school, i had seen a physical therapist for my back who was amazing, and i've felt all along that if i could have seen her when this all started, things never would have gotten to this point. i was actually able to get an appointment with an orthopedic doc who specializes in the back/spine today, and he took a few xrays and ordered an mri of my lumbar and sacral spine. the results of the mri will be back in a few days, so i guess we'll see what that shows. his exam was brief... he checked my reflexes, watched me bend forward and backward, touched my vertebrae, did the patrick's test (i think that was the name he gave for the si joint test :)?) after i asked if any of the symptoms could be from si joint dysfunction, and that was pretty much it. he didn't palpate any muscles around the spine or in the butt (which are all pretty much in spasm)... he didn't check my hamstrings... that was it. and our next 'visit' will be over the phone so i don't have to drive an hour into town. ugh. is this a typical exam by an orthopedic doc? for some reason i thought he'd be a lot more thorough. well, thank you again for your help. take care, and i'll look forward to hearing from you again soon! :)





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