Hello, this is my first post, but I have been reading this forum for a while. I am diagnosed with Pudendal Nerve Entrapment, currently taking Lyrica 100 mg. My symptoms are genital, rectal, and unilateral buttock pain, severe constipation, and urination issues. I am trying to experiment with Lidoderm patches to minimize the meds use. I will appreciate any suggestions regarding the placement for this particular nerve issues. Thank you.

I would try first a patch on the lower back just above the butt crack. You may have to tape it down, as that is a tough spot and they don't stick well.

You can cut them in half and put each half just to the side of the
spine there, to avoid some of the curves.

Give it two days.... (that would be a patch each day for 12 hrs).

If it does not work, go up the spine an inch a day, to see if you
hit the correct nerves.

This diagram shows the lower 3 sacral nerves from the spine.
Those would be your target.
http://www.flickr.com/photos/walkers...ge/3939144332/

This is another view:
http://www.google.com/imgres?imgurl=...QEwBA&dur=1944

your target is the lowest S-- nerves. S3, S4, S5.

Lidoderms may take a few days to penetrate...so give them time.
The relief will not be instant... but it may start within an hour if you hit the right spot.

Thank you so much, Mrs. D! I was hoping to hear from you. Taping is a good idea as it doesn't stay in place in that area. Should I use it as needed or it has to be consistent for some time?

I would use them every day for at least a month.

I had a remission of my meralgia in my right thigh, after 14 days.

This drug works by blocking sodium channels in nerves. This interrupts the signals. If the nerve is over-firing it will eventually "forget" with time.

If there is pathology present...something compressing it, or invading it, a remission is less likely.

When I started the Lidoderms I never expected a remission...just symptom relief. So when it happened, I was very pleased. It also demonstrates that nerves may get confused and fail to stop firing...which I didn't know about at the time.

Mrs. D,
I have PN; but since my L4-5 fusion, meds, etc., have a lot of pain in that same area. I do put the Lidoderm patch in the area you mentioned. Cutting in half has help to stay there without tape. But, and the big "but" (no pun intended) had no idea using the patch for a long period can possibly help interrup the pain signal. I would use the patch occasionally; maybe a couple in a month or two.

Thank you,

Gerry

I know they are expensive, but do try to use them for a time period of at least 2 weeks to a month.

I found that after my remission (my nerve was damaged from a C-section where an exploratory was also done to look for ovarian tumors and kidney tumors)... heat can reactivate the pain briefly now. Hot tubs, steam room, or heating pad will cause the nerve to "wake up". But those did not cause lasting trouble just "twinges" for a day or so. But the searing pain I had (like 100 bee stings or a lightning bolt) did remit. I am left with some mild numbness over the thigh, but that is really mild and not troubling.

@mrsd

that is amazing ! even one day with less pain is welcomed!!!!
I shall look into these patches as well, UK does not have topical gabapentin or such and maybe my gp knows about these patches

Mrs. D- I have the burning sensation again, in the left thigh only, it seems to have gotten worse as I am also having a spinal arthritis flare up with sciatica in that leg. Do you think a lidodrrm latch would help that? It is strong enough to wake me up several times at night.
Could a back flare up exacerbate all PN symptoms?

I think anything is possible...after reading for years here and elsewhere.

There is a huge storm front moving across the country...this can also lead to more pain. I typically always get pain from low pressure storm surges.

If you have the patches, put one over the lower lumbar area on that side, and see what happens. They don't stick well, so you may have to tape it down. It takes a bit of time for the Lidocaine to diffuse thru to your lower back. But I do recall you are on the thin side, so it might be faster for you.

MP pain goes down the FRONT of the thigh only. Sciatic pain is typically down the back of the leg. MP ends at the knee area, and is more of a stabbing pain, rather than burning. I put a half patch at the area under the inguinal ligament at the top the the thigh, near the hip, for MP intervention. There is the femoral nerve that comes out near the midline of the leg... which is different and innervates muscles.

Figure 2B on this site shows those 2 nerves and where to catch them.
http://www.aafp.org/afp/2000/0401/p2109.html

Figure 2A shows the sciatic nerve coming down the back of the thigh and buttocks. This placement is best on the very lower back, where the main nerve comes out the the L4 or L5 area.
The buttocks are too thick and may block the lidocaine actions.

It is best to catch the nerves higher up nearer the spine, than at the endpoints you feel pain. The lidocaine doesn't work well
at the endpoints, but will numb a while nerve axon instead. So placement is everything with these pain patches.