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Chronic Inner Thigh Pain

In about 2007 I was diagnosed with vulvodynia (chronic vulvar pain). After all the typical treatments amtriptoline, neurontin, gabapentin, physical therapy, muscle relaxants, topical creams, etc., my doctor finally to do last resort treatment of vestibulectomy. First surgery went okay but didnt help, so another doctor tried again. After the second surgery, I woke up with burning inner thigh pain. That was in 2010 and no one has been able to help with either condition.

My focus now is the chronic inner thigh pain. Fast forward to now, these are the things doctors have tried:

Lumbar spine wo contrast: not remarkable
Pelvis wo contrast: right pudendal neuralgia, mild edema across bilateral sacroiliac joint, mild degenerative arthritis of pubic symphasis
Cervical Spine: degenerative disc disease at t2
Brain: unremarkable

I've had several nerve blocks, none of which helped.

Pudendal nerve block
Obturator nerve block
Causal epidural block
Iliolingual block
Genitofemoral nerve block
Hydroplastic plexus block
Sacroiliac joint block
Ganglion imparts block
Differential spinal block

Medications include:

I've had nerve conduction studies, blood work, I've been tested for lyme disease, autoimmune disease

I've also tried accupuncture, massage therepy, chiropractor, physical therepy, yoga

Does anyone have any idea what my doctors could be missing? What is causing this pain. I've lived with the thigh pain for 8 years and the vulvodynia for three more than that! Let me know your thoughts. I may have missed something I've tried so I'll look through my records if you have questions. I'm running out of doctors I can go to.
2 Responses
20803600 tn?1546262537
When was the spine MRI? It may be that there is a compression of a spinal nerve in the lower lumbar area, which innervates that area of your body. Take a look at myotome and dermatome maps and you can locate the areas affected and see which spinal areas may be causing the issues.
The MRI was in January of 2017. The doctor that ordered the MRI did some blocks in my lower spine. I cant find the records that say exactly where he did them. I never head of the myotome and dermatome maps. I just checked them out. It looks like L2 & L3 possible L1 & L4 areas.
20803600 tn?1546262537
Did you consult a spine surgeon. When it comes to spine imaging, you really can't rely on just the reports. Surgeons look at the actual images, and see things not picked up by the imaging.
I have not. That's a good idea. I will look for one. I think my doctors have only looked at the reports.
Primaries, etc tend to rely on the reports, spine surgeons actually examine the images, understand dermatome/myotome maps, and your symptoms to form a diagnosis/treatment plan. Most times it does not involve surgery.
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st. louis, MO
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