JustAnswer > Health
Ask A Question|Register|Login|Help
JustAnswer

Health

Ask a Health Question, Get an Answer ASAP!

Have your own Health question?

15 Doctors and Nurses are Online Now
characters left:
Not a Health Question?

Related Health Topics:

  • May
  • ,
  • Lot
  • ,
  • Mri
  • ,
  • Run
  • ,
  • Back
  • ,
  • Bone
  • ,
  • Calf
  • ,
  • Cyst
  • ,
  • Fell
  • ,
  • Ever
Bookmark and Share

Question

I had a nerve block epidural steroid shot on Nov 2, 2009 for Crotch/ perineum pain. It seems to be working so far, but I’ve had three steroid shots this past summer that didn’t work, so I’m keeping my fingers crossed. I have the following problem: Crotch/ perineum pain, specifically on the right side, numbness on the bottom of my butt cheeks, hip pain, sciatic pain in my left leg. The doctor who gave me the nerve block shot Monday said there is a peripheral nerve that goes to the crotch area, but he didn’t know where it came from. Do you know which peripheral nerve goes to the crotch area? I had an MRI on July 8, 09 and it said: No significant disc bulge at T11-T12, T12-L1. At L1-2, there is a mild diffuse disc bulge without significant eccentricity. At L1-2, there is a mild diffuse disc bulge without significant eccentricity. At L3-4, no significant disc bulge. At L4-5, there is a small central left paracentral disc protrusion. At L5-S1 there is a moderate diffuse disc

Submitted: 16 days and 6 hours ago.
Category: Health
Value: $18
Status: CLOSED
+
Read More

Optional Information

Gender: Female
Age: 50

Already Tried:
IMPRESSION: Small central left paracentral protrusion at L4-L5. Diffuse moderate disc bulge at L5-S1. Diffuse mild to moderate disc bulge at L1-2, L2-3. The neurosurgeon did these tests and said there was nothing surgically he could do for me: 1) Nerve conduction velocity (NCV) study 2) Electromyography (EMG) Do you know what the treatment for all of this is? The doctor who gave me the nerve block epidural steroid shot also said females typically get inflamed crotches. Are there over the counter remedies for enflamed crotch? I’ve been dealing with this problem since July and I am really frustrated. I can live with the back and sciatic pain, but I can’t live with this horrible crotch pain. Thanks.

Posted by Dr. Mark 16 days and 6 hours ago.

Info Request

Are you having this pain only on one side of the crotch, the same side as your sciatica? Do you ride bicycles often? Did the epidural shot also help with the sciatica?

16 days and 5 hours ago.

Reply

The sciatica is on the left and the crotch pain is on the right. It's only on the right side of the crotch. Sometimes, it's an inflamed feeling and sometimes it's a stabbing throbbing pain on the right side. I'm sure the inflamed feeling is still there, but the stabbing pain is masking it. The eiprudal shot didn't help with the sciatia. I don't ever ride bicycles. Just gym bikes and I haven't been to the gym since April. I have a home exercise bike. I got dehydrated and delirious from taking lasix and throwing up for an unknown reason back in June. I rode the home exercise bike for 20 min a couple of days before they took me to the hospital in June for the dehydration and when they put me in the ambulance, my legs and butt were really, really sore like I had overdid it at the gym and it was really painful when they laid me down in the ambulance, but the pain went away after a few days. I haven't done any exercise basically since June (obviously). I got on the bike with the intention of riding it for 5 or 10 min and started watching TV, got distracted and accidentally went for 20. Before that, the last time I had done any type of exercise was back in April. Could this have anything to do with all of this? If so, is there a remedy? The very first symptoms I started having after I got out of the hospital was what felt numbness in the crotch area, which freaked me completely out. It was a novacine shot when you go the dentist. It's not numb, even though it feels numb. Then, the horrible crotch pain started. Can this be treated at home? Can you help me, please? What should I do now? Thank you.

16 days and 4 hours ago.

Reply

I forgot to tell you. The neurosurgeon did a meylogram on Oct 12 and all I know about it is what the nurse told me one day on the phone. She said there were some compressed nerves around the L4-L5 discs. I asked the neurosurgeon about the tests today and he still said there was nothing he could do for me surgically. They did an MRI on the thoratic spine and he said it didn't indicate anything, either. I signed a medical release to get the results of these tests myself on Oct 19, but haven't heard anything back from them. I left a message today to try and find out the status of this request, but I haven't heard anything back. Thanks.

Posted by Dr. Mark 16 days and 1 hours ago.

Answer

One of the more common reasons for pain in the groin area are issues with the nerves.

Given that your MRI doesn't show much, its not likely that the lumbar spine is the cause of this.

Of course, this could have changed between the MRI in July, and the myelogram on Oct 12th, so theoretically some compression of the nerves that run through this area could be the cause of pains. But you would have to wait for the actual results to find out.

Another possible reason, given your bicycle seat use history is the condition called "pudendal neuropathy" -- a nerve that heads toward the groin area that is often inflammed for many reasons, with bicycle riding the most common cause.

some good information is here:
http://www.pudendal.com/


16 days ago.

Reply

When I go to the gym, I only go 3 times a week, riding 20 min at a time and I hardly ever ride the bike at home. I just did it that one day because my orthopedic doctor told me not to do any weight bearing exercise because of a problem with my knee and I accidentally overdid it. I have been sitting a lot because of the bulging discs in my back, but the pain was there before that. This is the MRI done on May 20, 2009 on my knee. I don't know if this problem could be related. An EMG was performed on April 12 by his clinic because he thought the 2 might be related. I just happened to see my orthopedic doctor today right before I saw him, I asked for the MRI to give to the neurosurgeon. When I tried to show him the MRI, he said he doesn't read them. He was very uncommunicative and distant. This was only the 2nd time I've seen him. I asked him about the nerve compression around the L4-L5 area and he said couldn't do anything for me surgically. Here is what the MRI on my knee showed and my remaining questions.

 

1. Do you think the 2 might be related?

 

2. Does nerve compression heal itself? If he won't do anything surgically, what can I do for it?

 

3. I did have a fall when I was delirious because my family left me and I wandered around and I know I fell because I had a big gash on the back of my head. They did a CT scan of my head in the hospital and nothing was found there. I noticed on that website you gave me, it said it could be caused by a fall on the coccyx. Is it possible I have that and not know it? What tests are done for that and is there a solution to it? Would something like that have shown up on the meylogram? He never even suggested anything like that. Like I said, he was uncommunicative and distant, so I don't know if it occured to him. It's the first I've ever heard of it.

 

4. What is sacro-spinal fixation? Also, I have an overactive bladder which I take medication for. Could any of this be connected?

 

5th and final question. What kind of doctor should I go to to resolve all of this?

 

Impression of my left knee:

Bone bruise again seen involving the lateral patellar facet with cartilaginous loss about the lateral aspect of the joint. There is a moderate knee effusion with edema posterior to the knee joint space in the proximal calf muscalature likely a repruted Baker cyst. Other etiologies not entirely excludible. Bowed medial collateral ligament suggesting strain. Bone bruises as described above including the posterior insertion of the posterior cruciate ligament and posterior tibial plateau and the fibular head. Strain in the popliteus muscle also can be excluded.

 

Posted by Dr. Mark 15 days and 2 hours ago.

Answer

Sorry for the long delay. I had three long operations today and just finished for the day.

To answer your questions:

1). It does not sound that your L4-5 issues, or your symptoms are related to any issues with the knee.

2) Nerve compression that is minor usually improves on its own. The pains from nerve inflammation will generally improve with time.

3). Trauma to the area, such as from a fall, could have caused inflammation in that nerve, and sure -- a fall on the coccyx would also irritate that nerve, so certainly a possibility. Though again, bicycle seats are probably the #1 offender. Unfortunately, there aren't many tests that can help with diagnosis of this, besides the local nerve block.

4) Sacrospinous fixation is for treatment of vaginal prolapse. Lumbosacral fixation is for treatment of spinal disease. The medication for overactive bladder probably is unrelated.

5) You should probably try either an orthopedic surgeon, or a phsyiatrist, who deals with sports injuries, and can perform injections of that direct area to see if it helps with relief.

15 days ago.

Reply

I was asking if lasix can have anything to do with the crotch pain.

 

Can nerve compression around the L4-L5 cause pain in the crotch area by way of a peripheral nerve? The neurosurgeon did an EMG test. I'm assuming he concluded that there was no link between the knee and the back, so I'm discounting that.

 

My physical said that nerves grow .25 millimeters a month. Does nerve inflammation have a specific time frame like to heal, also?

 

How is nerve irritation around the coccyx diagnosed? What kind of test would it show up on? X-ray, MRI, or meylogram?

 

Thanks.

 

15 days ago.

Reply

Also, can nerve compression around the L4-L5 cause pressure on the bladder? I feel like I have to go every second now. Thanks.

Posted by Dr. Mark 14 days and 8 hours ago.

Answer

Simple compression from L4-5 would tend to affect the L5 nerve root, which would cause pain to radiate down the back of the leg -- not affecting the bladder.

So the left paracentral disc at L4-5 could be the cause of pain down your left leg, but not be related to bladder issues.

14 days and 8 hours ago.

Reply

Can nerve compression around the L4-L5 cause pain in the crotch area by way of a peripheral nerve?

 

How is nerve irritation around the coccyx diagnosed? What kind of test would it show up on? X-ray, MRI, or meylogram?

 

My physical said that nerves grow .25 millimeters a month. Does nerve inflammation/irration have a specific time frame like to heal, also?

Accepted Answer

Typically -- nerve compression at L4-5 should not cause crotch area irritation. That would generally be irritation of the sacral nerves, which are below this area.

This type of nerve irritation is often hard to diagnose, because it will not show up on xray, MRI or myelogram. It is a clinical diagnosis, though sometimes a nerve block can help to diagnose this (if the injection helps with the pain, then it is likely nerve irritation).

The rate of nerve growth has nothing to do with this. Inflammation often does take a few weeks to improve, so avoiding all activity that could be inflamming this nerve (e.g. sitting on the narrow bicycle seat) would be best.

Picture
Expert: Dr. Mark
Pos. Feedback: 99.8 %
Accepts: 
Answered: 11/7/2009

Doctor (MD)

U.S. Physician/Surgeon in Neurosurgery

+
Read More

Related Health Questions

  • Which anti malarial medication has the least side effects fr...
  • my mother was in the hospital she is 85 they told us that he...
  • My foreskin is sometimes real thight. And than it cracked.
  • How do you know if mold is causing your allergies. How can
  • hello very very scared as i felt weird in the head about 20
  • Hello, As I was walking down the stairs I strpped wrong and
  • I have this itching and burning from my knees to my toes.
  • say you had sex with your partner and he nutted inside of yo...



Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.
Question List | Become an Expert | Terms of Service | Security & Privacy | About Us
© 2003-2009 JustAnswer Corp.