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Nerve Entrapment Nerve Entrapment

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Unread 06-24-2009, 06:33 AM
Nerve Entrapment

I went to my gyn yesterday for my 2nd ultrasound in 2 months, the first one showed a large ovarian cyst on the left side, I had been in pain for a couple months beforehand and 1 1/2 years before had had a nerve block in the same area after 2 cat scans. After the first ultrasound 2 months ago after me moaning and groaning about the pain he did a nerve block as well. Didn't seem to work this time. So after the ultrasound yesterday he said the cyst had stayed the same and wants to leave it for another 3-4 months. He had me "point" to the pain and felt around. Said he could feel a nodule in my lower abdomen and feels it's a nerve entrapment. All I can say is it HURTS! It's sending pain into my back and it hurts to sit all day (I have a desk job). He's having me come back in a month for another nerve block but I'm wondering how the hell (sorry) I'm supposed to deal with this for another month before having another block? He said if the pain persists after that he will remove my ovary. I'm going on vacation in 2 weeks and there will be alot of walking. Don't know how I'm going to do it. Advil doesn't seem to help and I don't want to be drugged up and tired. Should I call and beg the office to get me in NOW for another nerve block? Or should I try to stick it out? I know, the obvious answer is to call and complain and I'm sure he'd see me with no problems but I feel so guilty and like such a complainer. Is there a permanent fix to this? I really don't feel like having needles stuck in my stomach all the time.
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Unread 06-25-2009, 12:14 PM
Re: Nerve Entrapment

I dealt with nerve pain following hernia repair almost 4 years ago.

First, I know what you mean about Advil not helping, and some of the "nerve" meds I tried made me feel really foggy. I would rather be in pain than on the meds.

I finally found limited success with the nerve blocks. Limited meaning that the relief would last 2-3 weeks at most. He couldn't safely keep injecting me that often. Similar to your situation, I was going to be traveling, and he agreed to (he actually suggested) one more nerve block to give me some comfort on my trip while I waited to schedule a different procedure. He was very compassionate and I know he didn't view it as me being a complainer.

As far as a permanent fix, I don't know the details of your situation and what nerve is affected. Mine was the ilioinguinal nerve. Since that one is purely a sensory nerve, and has no motor function associated with it, I had the option to have it ablated. The doctor used a technique called cryoablation to freeze the nerve, basically destroying its capability to transmit signals. It's a very precise thing, requiring the doctor to be able to locate exactly which nerve to target. And more accurately, it's not necessarily "permanent" but at least "long-term". My first treatment lasted about 9 months, and I had to have it repeated because the nerve started to regenerate (not uncommon). It's been 16 months since my second treatment, and I'm doing well so far. There's really no way to predict if or when the pain may return.

Hope this info helps a little. I can definitely relate to what you are going through. Take care.
Unread 06-25-2009, 12:29 PM
Re: Nerve Entrapment

ACW, thanks so much for your reply. It's always nice knowing you are not the only one. I have a call into the doc to ask if it's possible to get another block before the vacation instead of after. I know he'll agree as he's compassionate as well. I don't want to become dependent on these blocks though, and I have read that cortisone can thin the fascia wall and obviously don't want to do that either.
Did your gyn do your ablation or was it a general surgeon? I am going to talk to my gyn (that's who's diagnosed me and is doing the blocks) about what the next step is. My first nerve block was 2 years ago and lasted 18 months but for some reason this time it's not working. It's in my lower left, just about on the line of being considered the groin area I guess, in the area of the ovaries. I'm not having a pain IN my groin area as well that seems to go down into my legs. Hurts to sit at my desk all day. I have a semi-large cyst on my ovary (I think he said 2.3 cm's or so?) but he doesn't feel that is causing the pain. BUT, he said if it bothers me he can remove the ovary. I would rather try to get this nerve entrapment calmed down first to even know if the ovary is painful or not. He said he can feel a nodule in my lower abdomen where I am feeling the pain and is sure it is the nerve entrapment (had a cat scan quite some time ago and all was normal). He tried talking me into taking Elavil but after reading side effects, no way. I'm overweight as it is and have recently really started trying to lose weight, that would make me so depressed!
I had a neuroma in my foot removed last year and my gyn says it's common to have one in the abdominal area if you've had them in your foot, etc. WHo knows. But, thanks again for your reply, I'm hoping I can find out more about ablation...seems that will be the next step. Have read alot about alcohol injections as well.
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Unread 06-26-2009, 01:14 PM
Re: Nerve Entrapment

My nerve ablation was actually done by a pain management specialist. The general surgeon who did my hernia repair offered to open me up again and surgically sever the nerve, but I opted to try the cryoablation first since it was much less invasive.

There are a couple different methods of ablation out there. My pain doctor had mentioned RF (radiofrequency) ablation, and I've read about the alcohol injections, too. I don't know how many doctors out there are trained to do the cryo.

Best of luck to you.
Unread 06-26-2009, 01:47 PM
Re: Nerve Entrapment

Thanks Anita, they were able to get me in on Monday for another nerve block. I plan on asking where we go from here as I don't want too many of these, he does use a steroid as well and I know that tends to weaken and thin tissue. I just want this pain to be gone once and for all. I thought with my hysterectomy I'd be home free! Guess we all can wish, ha ha. Thanks so much for your insight.
Unread 06-26-2009, 02:15 PM
Re: Nerve Entrapment

I actually had surgery to sever the damaged nerves. Both my iliguinal (sp?) <you would think I could spell that darn word after all these years > Before having the surgery, I did have nerve blocks, in which the surgeon used steroids, did receive some relief,which is what led him to believe that the nerves were damaged. I do recall the doctor telling me that I could only get so many of those shots.

I did have some relief after the surgery, but pain started to come back. I would get an electrical zapping feeling, doc said that nerves can regenerate and that was probably what I was feeling.

The best thing that I did was to start accupuncture treatments. Since I have started, I rarely have any pelvic pain or pain in my incision area.

Unread 06-26-2009, 02:23 PM
Re: Nerve Entrapment

THanks Kim, I'm going to ask him Monday what he thinks. The first block I had lasted 18 months. Not sure why it's not working so well this time. I live in a fairly small town, no acupuncture around here unfortunately!

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