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Pudendal pain but MRI findings. Is this still TMS?

Discussion in 'General Discussion Subforum' started by Ewok, Dec 20, 2017.

  1. Ewok

    Ewok Peer Supporter


    I've had pudendal/pelvic floor pain for several years. No incident to start it, just random. (Further complicated by some menstrual irregularities but everything on that front has been ruled out it's just persistent and upsetting.)

    I had been staying away from doctors but after a big increase in pain to unmanageable levels, I was sent for a very detailed MRI which came back showing that the pudendal nerve was fine but there was some inflammation around it and one of the veins was a but enlarged, possibly congested.

    This scared me badly and my pain has been through the roof. Is it possible this is still TMS? Could tight muscles cause those findings? Is that just TMS? My doctor was basically not sure what to do and wanted to refer me to another state.

    Any thoughts?
  2. MWsunin12

    MWsunin12 Beloved Grand Eagle

    Yes. TMS is real. There is real inflammation. In Steven Ozanich's book he wrote about how he started to read Sarno and his hands became inflamed before his eyes and swelled up and turned bright red. It's because the unconscious wants you to focus on physical pain...which is real.
    There is nothing to be afraid of. The fact that the main nerve appears to be just fine lets you know that it is TMS.
    I write this to you because I went through pudendal nerve pain and once I told myself, "I am completely willing to believe that this is 100% psychological," the pain started to diminish and disappear.

    Please don't be afraid. Don't read about it on google. Before you go to seek advice elsewhere, maybe reread Great Pain Deception or a Sarno book.
    I'm going through a persistent symptom right now, too, affecting my Eustachian tube and tinnitus and sensitive gums.
    TMS is tricky. It knows how to convince us that something is really wrong.

    Wishing you well.
    Ewok likes this.
  3. Ewok

    Ewok Peer Supporter

    Thank you for your kind reply. I tell myself that but I just wish I could make a dent in the pain to gain some confidence and relief.
  4. Lizzy

    Lizzy Well known member

    I think getting scared and having your pain go through the roof is evidence that this is tms. Of course it would be nicer if your evidence was less pain, rather than more.

    A few years ago I was having mild menstual cramps when my daughter called to tell me her father-in-law died. My cramps, as you say, went through the roof. I tried to talk myself down, but was overwhelmed with grief and had to take ibuprofen. It taught me something about tms though. Let a flare that is directly tied to emotion teach you too. Let it build confidence.
    Ewok likes this.
  5. NicoleB34

    NicoleB34 Well known member

    i have PN and recently i was doing quite well, then after a stressful work week, i woke up with more pain than normal. it was pretty drastic, and i almost never wake up in immediate pain. i even woke up out of a sleep with pain. (never happens).
    I assumed it must be a pelvic floor knot. I know trigger points are controversial here, but i know i have "provoked pain" meaning, there are areas of my pelvis where if you press them, they burn and hurt! so a trigger point in the right spot will likely hurt. Anyway, i was right, i had a HUGE trigger point in a bad spot. My PT released it, but the relief was very temporary. I went back the next week and she said "hmm, the knot is back". Now, i get knots all the time, but never a recurring one in the same spot. This SCARED me. I almost wish i never knew. Why? because now for the last 8 weeks, i've been in extreme pain because that SAME knot keeps bouncing back in the SAME place. Now there's a new one that has recurred in another place. Just knowing i have a persistent knot is messing with my head. i believe i am making it come back. i believe my fear and stress is making my pain worse. i cant seem to come out of this rut.
    Ewok likes this.
  6. MWsunin12

    MWsunin12 Beloved Grand Eagle

    You can believe in trigger points. It makes sense that pain can localize at a start point. The question is...WHAT is psychologically causing the trigger points to be there. Your mind is getting unintentionally polluted by statements like; "Hmm...it's back."
    Look at your psychology /emotions. Write about the work week that was stressful. Not the facts of it. Write down what the stress reminded you of in your life. Did the stress make you want to fight, freeze, or flee? Then, look at how that response first developed in your life.

    Just some suggestions. Peace to you.
    P/S: Remember, you never heard about women with pelvic pain in the 60's, 70's, 80's. Did it not exist? Why now?
    Ewok and Lizzy like this.
  7. NicoleB34

    NicoleB34 Well known member

    pelvic pain, at least in the form of interstitial cystitis did exist back then because i heard of the awful treatments they used to do to them (like using silver nitrate to burn off their bladder linings), but they for the most part, it was considered a hysterical women's disease. Pelvic pain in men was always considered prostatitis. I think it existed, but it was always was called something else. I think many of these painful conditions that have many names can be lumped into chronic pelvic pain syndrome....which is largely TMS.

    Many of the books i read on mind/body approaches to pelvic pain are actually pro-pelvic PT, (because tight muscles are part of the equation. we hold tension in our pelvises). But they remind you it's only HALF the problem. The tension will always come back if you dont address the mental part of it. I told my PT that i dont want to know about the knots anymore. I used to ask her "so, what's up there now? what kind of knots? where are they? how close to the nerve?" i would obsess about it. Today she went up there and made a face like "ugh....." i knew it was bad. I told her today, "from now on...i dont want to know. I dont want to know about 'the knot'. i know if i ask about it, i will obsess about it. so, dont tell me". She agreed.
    Last night i was in horrific pain. I was trying to meditate, but i was breathing so shallow and heavy. My dog is getting elderly, so she's been pacing the house lately. All i hear is clack clack clack from her nails as she paces. So i got up and screamed "WHAT THE F*CK ARE YOU DOING?!" at the poor dog. I find myself doing this when i'm in bad pain. I get mean like a wounded animal. I am trying to relax and every tiny thing makes me crack when i'm in pain!!!
    Ewok likes this.
  8. MWsunin12

    MWsunin12 Beloved Grand Eagle

    Understood. Pain can overtake everything pretty rapidly. I'm sorry.
    Sending all good thoughts that it will resolve for you.
    Ewok likes this.
  9. Ewok

    Ewok Peer Supporter

    I stopped pelvic floor therapy because Dr. Sarno is pretty clear about it focussing on the body and he even talks specifically about trigger points. I know what you mean about the sudden increase of pain though and doing anything for relief. That has happened to me a few times now and you can just feel the muscle tightness so acutely. My thinking on physical therapy is that you mind can undo any good it does. I know several pelvic 'mindbody' people talk about PT e.g. Abigail Steidley and Lorraine Faehndrich, yet if you read their stories they didn't actually heal until after they stopped having the therapy... Do you mind if I ask if you have experienced any menstrual irregularities with your pelvic pain or does your period have any effect on your pain?
  10. plumshower

    plumshower Newcomer


    If you have pelvic congestion there is actually a method for curing this...you would need to see an interventional radiologist. I forget the exact technique but they inject something into the vein and in up to 80 percent of cases I believe the congestion is gone. It baffles me why some still consider congestion to be a controversial diagnosis when there is a treatment in existence that is both successful and not very invasive. Please Google it! I believe in TMS 100 percent but sometimes there are true physical things and thus true physical cures. If congestion is what is causing your PN I would definitely investigate this further. I would like to ask, as I have PN and have never been given the option of a more detailed MRI, what the name of the MRI was? I have myself suspected possible congestion. Anyway. Good luck!!
  11. Ewok

    Ewok Peer Supporter

    I've done some research and many doctors, including the Mayo Clinic, say that Pelvic Congestion is a bogus diagnosis in many cases because congestion is very common and frequently seen in people with no pain. Often 'curing' it had no effect on pain. Ezer on this forum (who recovered from PN) said he saw many PN people have treatment for congestion and it didn't work. The symptoms of it also aren't really similar to PN symptoms anyway.

    The MRI is MRI neurography I think, of pelvis. But Ezer had that too and it showed 'real' issues with his nerve and he still healed with TMS anyhow. Mine was really to look for something that might be growing or pressing on the nerve.
  12. NicoleB34

    NicoleB34 Well known member

    my period doesnt affect the pudendal pain, but it DOES affect the urinary pain and that seems to be a very common finding in females because there are estrogen receptors in the bladder. Some people believe that interstitial cystitis is TMS (i believe mine is, or at least some degree of central sensitization because it developed after a string of many untreated bladder infections) and you might say that since i get a mini flareup two days before my period is a "conditioned response" but in my case, i dont think it is, because i dont track my period at all. My menstural cycle is a bit irregular, so when i notice that i'm getting more urethral burn than normal, i'll glance at the calendar, count the days and say to myself "yeah, it's about that time when my period should be due" and then it comes. My theory is, if my brain is making my bladder more sensitive, then the horomones are provoking it even further. I have strong "provoked" pain, meaning that when you press the sensitive area, my pain goes thru the roof. like pressing a wound.

    i should point out an interesting development since i last wrote this about my triggerpoints and flare. i had a near mental breakdown around the time i wrote that. It was so bad that i walked downstairs in my office building, to a mental health business that has a bunch of therapists, and i straight up asked them if they had anyone who deals with chronic pain. I was hoping they had somebody similar to a Shchubiner or Alan Gordon. The girl behind the desk said "actually, in a couple weeks we have somebody starting up something to do with meditation. i can give you a card". I figured, good enough. it's a start. I took the card and left. The next day i woke up and felt different. I had a lot of anxiety (over something unrelated) but when i have strong stomach anxiety, the kind that can be felt as a tightness in the gut, it tends to leave my pelvis. it's almost like the tension just switches places. I'm telling you, i had ten weeks of severe pain, but that day i had nearly none. The day after that, my stomach wasnt as anxious, but i still had nearly no pain. For the next week, my pain was drastically lower. Of course i took advantage of this and rode my bike like crazy and that flared me up pretty bad for a couple nights (despite it being TMS, it still bugs the nerve to take a beating like that all at once when it's sensitive). I think that glimmer of hope from taking that card changed something in my brain.
    Sadly it was short lived. The pain is coming back. I had one upsetting misunderstanding (romantic spat) and even though it was resolved in a matter of an hour, i think that set off the pain. that was a week ago, but the pain is practically back to the level it was when i was in awful flare mode. I no longer am obsessed about trigger points, an i'm trying not to freak out because i know these flares can be temporary, so why is the pain so bad?! i was doing really good for a week! I think what upsets me is that all it takes is one tiny thing to put me into a flare that last weeks, even if i "get over it" mentally. Then it might take one little thing to bring me back out of that flare, just by accident. All i know is, i cant seem to control it.

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