New Member - 6 Months of Pelvic Pain

Hi everyone, I’ve recently discovered this forum through the posts of ezer on the pudendal hope forums. I always knew there was a strong mental component to my pain, but recently began to believe it after a sharp return of pain due to an increase in stress and emotional issues after a few days of almost absent pain.

My journey started at the beginning of February this year. I began experiencing burning with urinating. After a few days of this symptom not going away, as well as testicular pain, I began to panic about the possibility of having an STD. I went to the doctor for testing and was given antibiotics. All tests came back normal. The pain did not subside. After a couple of days, my girlfriend sat on my lap and I felt a sharp pain in my groin area. This pain gradually increased to severe levels. I made an appointment with a urologist who tested me for kidney stones. All tests came back fine and I was told that pelvic pain just happens for no particular reason and I would just need to deal with it. This caused me intense worry. I eventually made my way to a sports medicine doctor who diagnosed me with pubic symphysis after noticing pain near my pubic bone. I had an MRI done which showed only minor inflammation in the area. His treatment plan was to try core physical therapy. Around this time I also started with the addition of some pain with sitting in the perineum area and tailbone. I knew that this sort of therapy would not address these issues, so I sought out a pelvic floor physical therapist.

Physical therapy has consisted of various treatment methodologies such as trigger point release, skin rolling, and dry needling. My groin pain almost completely disappeared after my first 2 sessions, but I began with more severe tailbone pain. In one session this was treated using dry needling and I experienced an almost complete reduction of pain in that area. A few visits later during one physical therapy session, she worked on an area where I previously had surgery to fix an anal fistula, which left me with a scar in my perineum. When she worked this area I felt a lot of pain. She reasoned that the scar tissue could be an influencing factor and we began to focus on this area, as well as the obturator internus muscle, which was very painful to palpation. Previously, I haven’t had any pain with the scar tissue area, only maybe occasional sensitivity. The pain has continued since then and progressed, at least 2-3 months now. The pain is a dull ache mostly when sitting and walking and also a raw feeling at the surface. There have been times where sitting is very painful and I have to avoid it, which is hard with an office job. I have had temporary relief, mostly from the dry needling. I have had days where I was occupied and in a very good mood and noticed almost no pain, as well as days where I experienced a lot of emotional issues and stress where the pain returned severe. I also have pain that shoots into my leg from sitting and walking.

I am beginning to see that the pain is highly related to my emotional state. Throughout my life I have had issues with severe anxiety and panic attacks, as well as some obsessive-compulsive behaviors. My personality type is being a perfectionist and always nonconfrontational in public. I can see factors that emotionally may have contributed to the start of my symptoms and their worsening. After the breakup with my serious relationship with my girlfriend, I started with a large increase of severe pain. This subsided as I worked on my anxiety through neurofeedback. I had several days with very little pain. She recently reentered my life as a friend and I struggled with anxiety and feelings that I still have for her, which aligns with the recent increase in my pain.

The only fears I have now are of the nature of my pain. I still fear that my scar could be the cause for my pain, perhaps the scar tissue affecting the pudendal nerve and surrounding muscles. I fear that my pain will get worse by discontinuing physical therapy or seeking out other medical professionals. I am scared that by exercising or continuing to sit I am damaging a nerve or structure that is painful. I counter this with the knowledge that I went almost 10 years since my surgery with no pain in that area until now, so my nerve is likely not entrapped and only now becoming painful. But it is still difficult to move past the idea of a severe physical cause that may increase.

I had read Dr. Sarno’s The Mindbody Prescription and have started on the structured education program and Alan Gordon’s program. I have also ordered Dr. Schubiner’s Unlearn your Pain and began journaling. Any other pelvic pain sufferers (or prior sufferers) have any advice on beginning this process?

 

Hello ac2448,
This is the answer to your problem, your story sounds like the most classical TMS case ever. I dealt with the same symptoms and completely knocked out PN/CPPS via the mindbody approach. Basically just by forgetting about it and moving on with my life.
If you want to make sure if this is TMS or structural, ask your self these 2 things:
1- is the pain persistent in one location or moves around? Also has it changed overtime by the diagnoses you were given by doctors?
2- does it change in intensity? for instance significantly reduces during vacations, when completely distracted, disappears during sleep ?
I guess you partly answered the second question in your post.
Please go over Alan Gordon's program, imo if applied consistently and patiently it's hands down the best tool to beat CPPS. The key is to accept the pain as it is and not occupy with it and reconnecting with negative emotions via the somatic tracking.
Also you can look up these accounts who beat CPPS, they will be a great source of inspiration during your recovery: @ezer, @c90danwaiel , @TimmyH

 

Thank you for your reply CarboNeVo,

Yes, the pain has moved around since starting, having begun as urinary symptoms only to severe groin pain to tailbone pain and finally severe perineum pain. The pain I now have in the perineum and where I have the surgery scar has been the longest lasting and most persistent pain. I don't think I have a basis of blaming the scar tissue for the cause of this pain, as this surgery was almost 10 years ago and I have never experienced pain until just recently when it was first worked on during physical therapy

The change in intensity is what led me here. I was convinced that my great relief came from the dry needling treatment to my obturator internus muscle, but the pain returned when I began to have some emotional issues and anxiety return. I looked back and noticed that when I felt the days with very little pain, I was generally feeling very positive and confident and busy doing enjoyable things. I have no pain with sleep and wake up with very little to no pain. The pain begins to start about 10 minutes after waking up.

 

Hello ac,
I went through the same.. sleep totally fine, pain came upon waking up and the pain changed depending on the dignose, first I was diagnosed with a non bacterial prostatitis, it felt as if there was a hand of a demon in my perineum, awful burning of prostate.
Later the inconsistency in symptoms led me to the pelvic floor dysfunction diagnose - pain changed character and I felt it in the muscles of my plvic floor.
PT and chiro confirmed extremely tense muscles - now I started dealing with levator ani, coccyx pain + on and off IBS symptoms which only worsened the pain.
Lastly I came upon the pudendal site, thats when the horror started, the pain literally shifted to my left pudendal nerve, felt as if there was a wire of fire burning the left side of my pelvis - prostate pain totally gone at that point, i was suicidal, especially that such diagnose is more or less a sentence for a life in chronic pain. Then i discovered ezer, sarno, this site...
Im writing this to emphasize how a psychognic pain can change. What I find the best way to tackle TMS is a change of awareness and focus - just forget about it and go do something that will get you out of your head (distracted) - it will render that chatter of negativity and fear around your symptoms useless. You have probably noticed that when distracted not worried about the symptoms.

 

You both should stop reading the pudendal hope homepage! It feeds the fear. There is a very unhealthy relationship between some patient advocate groups and parts of the medical establishment, especially pharmaceutical companies who want to sell their stuff. Instead concentrate on the TMS work and enjoy life

 

My situation is alittle similar in that mine started in February too started with lower back pain and progressed into urinary symptoms. The only time I was pain free was when i was on bactrim maybe because at the time my doctor told me I was fine and I believed her. Or the bactrim maybe gave me an antiflammatry effect. After stopping it due to side effects the symptoms came back.

I saw a urologist in July and after an ultrasound and cystoscopy to rule out pshyical causes he said I'm fine.

When I got into my car I cried because I didn't know what was wrong with me.

Ironically my urinary symptoms have calmed down dramatically but my lower back pain has gone back to when this first started in February. I feel its tms I just gotta put in the work.

Right now I'm trying to just enjoy life dispite the pain and try not to fear it . I also been excersicing af the gym again and it definitely helps ( I have no pain when I'm working out). I know my anxiety and fear is making it worse and it was starting to get better just a few weeks ago.