Dr. Renney - The main symptom is pain with sitting. You feel great in the AM until you sit for coffee, or drive to work. You get better with lying down. The pain is in the distribution of the pudendal nerve....genitalia, perineal or rectal. It can be any combination of these areas depending on the part of the nerve entrapped.

Dr. Renney - If the rectal sphincter is injured during childbirth, you probably had a difficult delivery so the pudendal nerve could be stretched or injured. It is not a result of a rectal muscle tear with an episiotomy. Jill O. - Thank you Dr. Renney for appearing tonight.

Dr. Renney - PNE is entrapment of the nerve either at the Ischial Spine, between the two ligaments or in Alcocks canal where it is covered by fascia. (Female Nerve Diagram & Male Nerve Diagram) A majority of the cases are at the spine. The nerve resembles the violin strings. It is stretched and does not lie flat. When you sit, tension is placed on the nerve and you have pain. This can also happen during a bowel movement. Some people have it with sexual relations. Dr.

Dr. Renney - The main point is the history. You need to ask specific questions and you can discover the difference. We see many patients with this diagnosis that actually had PNE.

Dr. Renney - A good example, a patient goes to Mayo clinic for a week, lays around in a hotel, has tests done, and feels great. The reason, he didn't sit, commute or work. So, yes, it depends on level of activity

PNE is so rare and understanding of it is so recent that in most cases it goes misdiagnosed or undiagnosed for years. As one article says: quot;Most patients felt hopelessly isolated as the world's only victim of a malady without a name. Patients wondered whether their imagination was the source, but they knew it was not. They report that acquiring a name for their affliction and contacting other sufferers gave important help even while symptoms persisted.

Dr. Renney - 2/3 of PNE cases are men. We have not found any real difference in symptoms between men and women. Dr. Renney - The original studies were done in cyclists. The other causes are similar to those you mentioned. You can add chronic constipation to that list.

Dr. Renney - Yes, don't do anything if it hurts! The only way to diagnose the difference is at surgery. Dr. Renney - If you have pelvic spasms, whether its from IC or PNE, you need to have this evaluated by a person who knows how to deal with pelvic muscles. Remember, sometimes with PT you get worse before you get better due to the chronic spasms.

Dr. Renney - Yes, because the muscles of the pelvis go into spasms due to the chronic pain. Physical therapy should be directed by someone with interest in the pelvic muscles, not just any physical therapist.

Dr. Renney - CT guided pudendal nerve blocks are done at the level of the spine or canal in the buttocks area. They are not the same as nerve roots are done at the lower spine, a different area and different result.

The problem is over-pronation: therefore the patient should be fitted with custom orthotics and proper footwear. Recovery can be expected to occur over a period of months. Orthotics will not cause the physical deformity to regress, but will arrest any further progression and likely stop the pain. It is important to note that when the bunion is severe and requires surgery, the bunion can be corrected, but will re-develop unless the root cause of over-pronation is corrected.

Everything from body aches, brain fog, mental confusion to CFS, fibromyalsia, interstitial cystitis, digestive disorders, depression, IBS, bowel disturbances, learning disabilities, loss of energy ?

The most common symptom is pain at the entrance of the vagina. Some patients experience pain upon external touch or stimulation of the vulvar region, while others have symptoms even without any type of stimulation. Patients typically complain of burning, itching, dryness, rawness and a drawing sensation. The symptoms may range from mild to severe. The vulva discomfort ranges from a feeling of being swollen to piercing and stabbing pain.

Many adults have a tear and do not even know it. These are typically degenerative or attritional tears. Painful tears in adults are usually larger, "flap" tears. They will cause pain with kneeling, squatting, pivoting, going downstairs and occasionally they will even hurt at night when you roll over in bed.

The common symptoms of seasonal flu are fever, headache, fatigue, dry cough, sore throat, nasal congestion, and body aches.