T Nation

Pudendal Nerve Problem?


#21

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#22

Thanks for the heads up.

Has anyone ever heard of the piriformis becoming so big and inflamed that it aggravated the pudendal nerve?

I am starting to think that this could be a big part of my problem, which would be great, because I know that it is relatively easy to cure.

My friend who checked me out claimed mine was about the size of his forearm.

If anyone has any experience with this please post your advice.

Thanks,


#23

I actually just joined this site because of this thread. I am a weightlifter that has been suffering from what I now believe to be a tight pelvic floor for months now. My condition is pretty bad because my penis is now numb and painful. Also, my testicles are tight. In fact, what BackinAction said about having your penis bend to one side sounds similar to my present condition. However, I must add that there were other circumstances besides weightlifting which caused my condition. I think my poor sitting posture put a lot of strain on my pelvic floor.

Recently, I tried stretching my piriformis muscles. I overstretched and instead wound up aggravating the piriformis muscles on both sides. Once I did this, I felt my penis became more numb and painful. Thus, I have come to the conclusion that my issues are just due to extremely tight pelvic floor muscles. But I think there are more muscles involved than just the piriformis. Also, I have done MRI scans and they showed no spinal disc compression.

Right now, I am pretty desperate and would love to talk to the physical therapist that BackInAction consulted. With a condition like this, you really do need to meet with someone that knows their stuff.


#24

[quote]biff7686 wrote:
I actually just joined this site because of this thread. I am a weightlifter that has been suffering from what I now believe to be a tight pelvic floor for months now. My condition is pretty bad because my penis is now numb and painful. Also, my testicles are tight. In fact, what BackinAction said about having your penis bend to one side sounds similar to my present condition. However, I must add that there were other circumstances besides weightlifting which caused my condition. I think my poor sitting posture put a lot of strain on my pelvic floor.

Recently, I tried stretching my piriformis muscles. I overstretched and instead wound up aggravating the piriformis muscles on both sides. Once I did this, I felt my penis became more numb and painful. Thus, I have come to the conclusion that my issues are just due to extremely tight pelvic floor muscles. But I think there are more muscles involved than just the piriformis. Also, I have done MRI scans and they showed no spinal disc compression.

Right now, I am pretty desperate and would love to talk to the physical therapist that BackInAction consulted. With a condition like this, you really do need to meet with someone that knows their stuff. [/quote]

Thanks for posting man,

I am sorry to hear about your condition, I know that it sucks, but I am really starting to think that both of our problems can be helped by GOOD therapy.

I am sure that BackInAction will send you information about his therapist as soon as he sees your post.

Do you get pain anywhere else besides the areas your mentioned.

I hope to get some more expert advice via this thread, please if anyone has good info. pass it along. I believe T-Nation is a great website in a lot of ways, with all of the very smart and informed people that are members / contributors to this sight I am sure that a flow of useful information can be obtained.

God Bless,
bamit


#25

[quote]bamit wrote:

[quote]biff7686 wrote:
I actually just joined this site because of this thread. I am a weightlifter that has been suffering from what I now believe to be a tight pelvic floor for months now. My condition is pretty bad because my penis is now numb and painful. Also, my testicles are tight. In fact, what BackinAction said about having your penis bend to one side sounds similar to my present condition. However, I must add that there were other circumstances besides weightlifting which caused my condition. I think my poor sitting posture put a lot of strain on my pelvic floor.

Recently, I tried stretching my piriformis muscles. I overstretched and instead wound up aggravating the piriformis muscles on both sides. Once I did this, I felt my penis became more numb and painful. Thus, I have come to the conclusion that my issues are just due to extremely tight pelvic floor muscles. But I think there are more muscles involved than just the piriformis. Also, I have done MRI scans and they showed no spinal disc compression.

Right now, I am pretty desperate and would love to talk to the physical therapist that BackInAction consulted. With a condition like this, you really do need to meet with someone that knows their stuff. [/quote]

Thanks for posting man,

I am sorry to hear about your condition, I know that it sucks, but I am really starting to think that both of our problems can be helped by GOOD therapy.

I am sure that BackInAction will send you information about his therapist as soon as he sees your post.

Do you get pain anywhere else besides the areas your mentioned.

I hope to get some more expert advice via this thread, please if anyone has good info. pass it along. I believe T-Nation is a great website in a lot of ways, with all of the very smart and informed people that are members / contributors to this sight I am sure that a flow of useful information can be obtained.

God Bless,
bamit
[/quote]

My pain is mostly located in the penis and testicle area. Although after I strained my piriformis I have experienced pain in the piriformis and coccyx region. I figure I really need therapy to relax the pelvic floor muscles. As BackInAction said, there really aren’t any tests to diagnose this condition. Although, I would suggest a visit to a urologist and neurologist. But do not expect them to know much about this ailment.


#26

[quote]biff7686 wrote:

[quote]bamit wrote:

[quote]biff7686 wrote:
I actually just joined this site because of this thread. I am a weightlifter that has been suffering from what I now believe to be a tight pelvic floor for months now. My condition is pretty bad because my penis is now numb and painful. Also, my testicles are tight. In fact, what BackinAction said about having your penis bend to one side sounds similar to my present condition. However, I must add that there were other circumstances besides weightlifting which caused my condition. I think my poor sitting posture put a lot of strain on my pelvic floor.

Recently, I tried stretching my piriformis muscles. I overstretched and instead wound up aggravating the piriformis muscles on both sides. Once I did this, I felt my penis became more numb and painful. Thus, I have come to the conclusion that my issues are just due to extremely tight pelvic floor muscles. But I think there are more muscles involved than just the piriformis. Also, I have done MRI scans and they showed no spinal disc compression.

Right now, I am pretty desperate and would love to talk to the physical therapist that BackInAction consulted. With a condition like this, you really do need to meet with someone that knows their stuff. [/quote]

Thanks for posting man,

I am sorry to hear about your condition, I know that it sucks, but I am really starting to think that both of our problems can be helped by GOOD therapy.

I am sure that BackInAction will send you information about his therapist as soon as he sees your post.

Do you get pain anywhere else besides the areas your mentioned.

I hope to get some more expert advice via this thread, please if anyone has good info. pass it along. I believe T-Nation is a great website in a lot of ways, with all of the very smart and informed people that are members / contributors to this sight I am sure that a flow of useful information can be obtained.

God Bless,
bamit
[/quote]

My pain is mostly located in the penis and testicle area. Although after I strained my piriformis I have experienced pain in the piriformis and coccyx region. I figure I really need therapy to relax the pelvic floor muscles. As BackInAction said, there really aren’t any tests to diagnose this condition. Although, I would suggest a visit to a urologist and neurologist. But do not expect them to know much about this ailment.
[/quote]

I am going to see my GP one more time because my father suggested it, he really trust the guy as do I. I am not expecting him to know much about my problems, but you never know, at the very least I hope that he can guide / direct my treatment in positive and beneficial directions.

Also, I am going to get worked on by an NMT Tuesday afternoon.

I will post how it all goes.

If anyone else has anymore info. please post it, especially those who have overcome similar conditions.

Regards,
bamit


#27

[quote]bamit wrote:

[quote]biff7686 wrote:

[quote]bamit wrote:

[quote]biff7686 wrote:
I actually just joined this site because of this thread. I am a weightlifter that has been suffering from what I now believe to be a tight pelvic floor for months now. My condition is pretty bad because my penis is now numb and painful. Also, my testicles are tight. In fact, what BackinAction said about having your penis bend to one side sounds similar to my present condition. However, I must add that there were other circumstances besides weightlifting which caused my condition. I think my poor sitting posture put a lot of strain on my pelvic floor.

Recently, I tried stretching my piriformis muscles. I overstretched and instead wound up aggravating the piriformis muscles on both sides. Once I did this, I felt my penis became more numb and painful. Thus, I have come to the conclusion that my issues are just due to extremely tight pelvic floor muscles. But I think there are more muscles involved than just the piriformis. Also, I have done MRI scans and they showed no spinal disc compression.

Right now, I am pretty desperate and would love to talk to the physical therapist that BackInAction consulted. With a condition like this, you really do need to meet with someone that knows their stuff. [/quote]

Thanks for posting man,

I am sorry to hear about your condition, I know that it sucks, but I am really starting to think that both of our problems can be helped by GOOD therapy.

I am sure that BackInAction will send you information about his therapist as soon as he sees your post.

Do you get pain anywhere else besides the areas your mentioned.

I hope to get some more expert advice via this thread, please if anyone has good info. pass it along. I believe T-Nation is a great website in a lot of ways, with all of the very smart and informed people that are members / contributors to this sight I am sure that a flow of useful information can be obtained.

God Bless,
bamit
[/quote]

My pain is mostly located in the penis and testicle area. Although after I strained my piriformis I have experienced pain in the piriformis and coccyx region. I figure I really need therapy to relax the pelvic floor muscles. As BackInAction said, there really aren’t any tests to diagnose this condition. Although, I would suggest a visit to a urologist and neurologist. But do not expect them to know much about this ailment.
[/quote]

I am going to see my GP one more time because my father suggested it, he really trust the guy as do I. I am not expecting him to know much about my problems, but you never know, at the very least I hope that he can guide / direct my treatment in positive and beneficial directions.

Also, I am going to get worked on by an NMT Tuesday afternoon.

I will post how it all goes.

If anyone else has anymore info. please post it, especially those who have overcome similar conditions.

Regards,
bamit[/quote]

Honestly, they probably will just do a urine test and find nothing. It doesn’t hurt to check with the regular doctor, but don’t expect anything beside clear bill of health. Urologists will probably tell you this is prostatis, but won’t detect any bacteria causing this. That’s cause it’s not prostatis, it’s tension in the pelvis which compresses EVERYTHING.

Let us know how it goes.


#28

Hey I have been fighting a simliar issue for a couple of years now. Mine started from Mountain bike riding. Symptoms for me were pain when siting, intense stomach pain and urinary issues. Since I sit at work for 45-60 hours a week at a computer sitting my biggest problem.

It also sounds like we have simliar insurance. My high deductable plan has a family cap of $5500 a year. This problem has drained our HSA!

Here is a list of of “experts” I have spent my money on.
-Family doctor (sent me to uroligist)
-Uroligist said it was prostatis (put me on 8 weeks of antbiotics and Flomax) The Flowmax helped some because it helps the muscles relax. After still having issues he sent me to Physical therapist.
-Physical therapist did internal release and discovered I had unequal length legs.(which turned out to be not true more on that later) She also helped get my hips back into place which were twisting my back out of place. After racking up over $2500 and mild improvement I decided I couldn’t spend any more money there since things had stopped improving. She had also explained trigger points to me.
-Went to a chiropracter to see if he could help my back and hips. Heard a simliar story about my legs being different length. Since I’m 39 years old you think I would’ve heard about this before now.
-Went to the library and checked out a book on doing trigger points. (http://triggerpointbook.com/) Wow what an eye opener. Book had a small section about piraformis syndrom.(http://en.wikipedia.org/wiki/Piriformis_syndrome) Which it said could cause every single problem I was having! I have tried the trigger point stuff in the book with out alot of sucess on my own.
-I’m now going to a massage therapist who does trigger points/ deep muscle/ ART and am once again improving.

As other people in here have said the issue is tightness/swelling in the piraformis muscle. Sounds like yours is pinching the nerve. Mine pulls my hips out of place causing pinching in my spine.

Now I have seen actual improvement with weightlifting. I beleieve the biking created imbalance in my muscle strength and put extra stress on the piraformis muscle. It also was being bothered by sitting all day which caused it to flair up. I have been trying to slowly build strength in my muscles with a very balanced weightlifting plan. I feel better right after exercising. (although recovery days tend to be very sore) I have issues with very tight hamstrings too.

What streches have people been using for this issue?

Have you seen the article on this site http://www.tmuscle.com/free_online_article/sports_body_training_performance_repair/tight_stiff_and_buttless
It has some useful information in it too.

Good luck and know that you are not alone and it more than likely is nothing serious just really really anoying!


#29

[quote]Keiserblade wrote:
Hey I have been fighting a simliar issue for a couple of years now. Mine started from Mountain bike riding. Symptoms for me were pain when siting, intense stomach pain and urinary issues. Since I sit at work for 45-60 hours a week at a computer sitting my biggest problem.

It also sounds like we have simliar insurance. My high deductable plan has a family cap of $5500 a year. This problem has drained our HSA!

Here is a list of of “experts” I have spent my money on.
-Family doctor (sent me to uroligist)
-Uroligist said it was prostatis (put me on 8 weeks of antbiotics and Flomax) The Flowmax helped some because it helps the muscles relax. After still having issues he sent me to Physical therapist.
-Physical therapist did internal release and discovered I had unequal length legs.(which turned out to be not true more on that later) She also helped get my hips back into place which were twisting my back out of place. After racking up over $2500 and mild improvement I decided I couldn’t spend any more money there since things had stopped improving. She had also explained trigger points to me.
-Went to a chiropracter to see if he could help my back and hips. Heard a simliar story about my legs being different length. Since I’m 39 years old you think I would’ve heard about this before now.
-Went to the library and checked out a book on doing trigger points. (http://triggerpointbook.com/) Wow what an eye opener. Book had a small section about piraformis syndrom.(http://en.wikipedia.org/wiki/Piriformis_syndrome) Which it said could cause every single problem I was having! I have tried the trigger point stuff in the book with out alot of sucess on my own.
-I’m now going to a massage therapist who does trigger points/ deep muscle/ ART and am once again improving.

As other people in here have said the issue is tightness/swelling in the piraformis muscle. Sounds like yours is pinching the nerve. Mine pulls my hips out of place causing pinching in my spine.

Now I have seen actual improvement with weightlifting. I beleieve the biking created imbalance in my muscle strength and put extra stress on the piraformis muscle. It also was being bothered by sitting all day which caused it to flair up. I have been trying to slowly build strength in my muscles with a very balanced weightlifting plan. I feel better right after exercising. (although recovery days tend to be very sore) I have issues with very tight hamstrings too.

What streches have people been using for this issue?

Have you seen the article on this site http://www.tmuscle.com/free_online_article/sports_body_training_performance_repair/tight_stiff_and_buttless
It has some useful information in it too.

Good luck and know that you are not alone and it more than likely is nothing serious just really really anoying!

[/quote]

Hi Keiserblade,

Glad to hear your on the right path after going down the path of the “experts”. Honestly, I did the exact same thing so I here ya. I think this will be a good thread that will help a lot of people on the internet.

The stretches that helped me most were assisted stretches from the ART practioner. Beyond that, it was this elevated lunge stretch we’re you put your front leg on a box and while staing in a lunge position, move your hips forward and back, side to side, and then circles. In addition, stretching the hamstrings and adductors was a must. I have to stretch psoas as well as these have been locking up and causing pain in my spermatic cord area.


#30

Alright, so I saw and NMT yesterday and my GP today.

Advice from NMT:

  1. This guy is the shit. Not only is he as high as he can go with NMT education, he is also Poliquin level 1, biosig. level 2, I think CHEK 1.

  2. Upon working on me he said that I have 5 areas in right glute alone that need work. The periformis, glute med., medial hamstring, adductor (I know not part of the glutes, but he did hit it via the perineum) thats all I can remember. After the session I felt great.

  3. His opinion is that all these problems are causing my symptoms, he said that PNE would be a worst case scenario.

  4. Also, something that is important to note is the fact that it was an hour drive to get to his place; therefore, it was an hour drive back, neither of which caused my symptoms to get much if any worse. I take this as a good sign.

GP’s opinion:

  1. He has heard of PNE and has treated people with it, he believes that if it is my pudendal nerve acting up it is because of inflammation around it, much like my friend who is a CHEK practitioner said.

  2. He believes that all of my problems are soft tissue related, therefore stretching and therapy along with not lifting for at least one month is the way to treat it. After about 4 to 6 weeks he believes that I should be 100%.

  3. I asked him if he had ever heard of bikers with PNE and he had treated some, he said that most of their symptoms diminished with time, in other words their definite PNE was reversible.

  4. He does not think that I need to see a urologist at this time.

All in all both experiences were pretty positive, I am lucky that I have good help around me from my great friend who is a CHEK 3, to the very competent NMT, do a very knowledgeable and relatively progressive doctor who is not surgery happy or money hungry.

I hope that my condition continues to improve, it seems like it is at least going in the right direction.

If anyone has any questions / advice please post.

IF anyone has had similar symptoms which went away after about a months rest, please let us all know.

God Bless,
bamit


#31

[quote]bamit wrote:
Alright, so I saw and NMT yesterday and my GP today.

Advice from NMT:

  1. This guy is the shit. Not only is he as high as he can go with NMT education, he is also Poliquin level 1, biosig. level 2, I think CHEK 1.

  2. Upon working on me he said that I have 5 areas in right glute alone that need work. The periformis, glute med., medial hamstring, adductor (I know not part of the glutes, but he did hit it via the perineum) thats all I can remember. After the session I felt great.

  3. His opinion is that all these problems are causing my symptoms, he said that PNE would be a worst case scenario.

  4. Also, something that is important to note is the fact that it was an hour drive to get to his place; therefore, it was an hour drive back, neither of which caused my symptoms to get much if any worse. I take this as a good sign.

GP’s opinion:

  1. He has heard of PNE and has treated people with it, he believes that if it is my pudendal nerve acting up it is because of inflammation around it, much like my friend who is a CHEK practitioner said.

  2. He believes that all of my problems are soft tissue related, therefore stretching and therapy along with not lifting for at least one month is the way to treat it. After about 4 to 6 weeks he believes that I should be 100%.

  3. I asked him if he had ever heard of bikers with PNE and he had treated some, he said that most of their symptoms diminished with time, in other words their definite PNE was reversible.

  4. He does not think that I need to see a urologist at this time.

All in all both experiences were pretty positive, I am lucky that I have good help around me from my great friend who is a CHEK 3, to the very competent NMT, do a very knowledgeable and relatively progressive doctor who is not surgery happy or money hungry.

I hope that my condition continues to improve, it seems like it is at least going in the right direction.

If anyone has any questions / advice please post.

IF anyone has had similar symptoms which went away after about a months rest, please let us all know.

God Bless,
bamit
[/quote]

Sounds like you’re in good hands. Biking riding definitely compresses that area, so if you’re one of those “bike 10 miles a day people”, stop that. It’s not healthy, just like many of the other things people think are normal.


#32

[quote]bamit wrote:
Alright, so I saw and NMT yesterday and my GP today.

Advice from NMT:

  1. This guy is the shit. Not only is he as high as he can go with NMT education, he is also Poliquin level 1, biosig. level 2, I think CHEK 1.

  2. Upon working on me he said that I have 5 areas in right glute alone that need work. The periformis, glute med., medial hamstring, adductor (I know not part of the glutes, but he did hit it via the perineum) thats all I can remember. After the session I felt great.

  3. His opinion is that all these problems are causing my symptoms, he said that PNE would be a worst case scenario.

  4. Also, something that is important to note is the fact that it was an hour drive to get to his place; therefore, it was an hour drive back, neither of which caused my symptoms to get much if any worse. I take this as a good sign.

GP’s opinion:

  1. He has heard of PNE and has treated people with it, he believes that if it is my pudendal nerve acting up it is because of inflammation around it, much like my friend who is a CHEK practitioner said.

  2. He believes that all of my problems are soft tissue related, therefore stretching and therapy along with not lifting for at least one month is the way to treat it. After about 4 to 6 weeks he believes that I should be 100%.

  3. I asked him if he had ever heard of bikers with PNE and he had treated some, he said that most of their symptoms diminished with time, in other words their definite PNE was reversible.

  4. He does not think that I need to see a urologist at this time.

All in all both experiences were pretty positive, I am lucky that I have good help around me from my great friend who is a CHEK 3, to the very competent NMT, do a very knowledgeable and relatively progressive doctor who is not surgery happy or money hungry.

I hope that my condition continues to improve, it seems like it is at least going in the right direction.

If anyone has any questions / advice please post.

IF anyone has had similar symptoms which went away after about a months rest, please let us all know.

God Bless,
bamit
[/quote]

Wow, you are lucky to have found a NMT with hands on experience with treating these issues! I’m sure you will have much better results due to finding someone so soon after the issues started. I know I’m having issues getting rid of it since it took so long to find someone who actually knew what the main cause was rather just treating symptoms.
I’m glad to hear your NMT was successful with treating bike rider problems too. I loved riding my bike but have given it up completely the risk/pain is just not worth it to me. Thanks for asking and relaying that info!


#33

Update:

Static stretching 5 - 6 times a day is really helping.

I went to my NMT yesterday morning and had some pain all day, I think that this was caused by mild inflammation from the trigger point therapy he performed, can anyone tell me from their personal experience or knowledge in the area if this is a valid theory?

I took some Advil and the pain, which was never really that bad, diminished significantly.

FYI for all those that may be having similar problems, the butterfly stretch against a wall is great at relieving some of the symptoms, especially the pain in the penile area.

God Bless,
bamit


#34

I will definitely try the butterfly stretch against a wall. Thanks, bamit! Keep up the good work.


#35

Update:

As of today I have to say that I feel like I felt better about a week ago.

The pain that I have seems to originate from extreme upper / inner thigh, right on the border of my inner glute and perineum, it will often radiate about a quarter of the way down via my inner hamstring. I am thinking that this is my tight medial hamstring along with very tight external rotators of the hip.

If this was the only pain I was having I would not be worried, but I still get some very quick shooting pains to my penile area, along with some tugging sensations now and again.

The penile pains do not last long, only about 2 seconds, I am trying hard to pinpoint where the pain is coming from. It seems as though it could be originating from either my right hip flexors / adductors or from my abs of all places.

Or it could be from the pain area I mentioned first in this e-mail

It does worry me that I am not able to locate the source.

Sitting down does not seem to make things much if any worse, in fact the penile pain usually comes when standing.

As you can tell from this post I am kind of mixed up as of now.

Those that have had any experience with this in any way please let me know how long it took to see dramatic improvement.

God Bless,
bamit


#36

OK guys I think i may know where my pain is coming from. I believe that the source of all my pain is form a stained or pulled obturator internus muscle.

Looking at the anatomy o the pelvis I determined that my constant pain originates from the Ischium of the pelvis. the obturator internus originates from this spot, and it is said tht if it is injured the pain can radiate to the penile area.

has anyone ever had any experience with this, I read that it takes a while to heal up, but the problem is not that serious.

So if anyone else is having pain which feels like it originates form the extreme upper / inner hamstring, almost in the perineum, which refers to the penis this could be your problem.

I beg anyone who has had any experience with this to post here please.

I will probably start another thread.

Hope this helps any who need it.

God Bless,
bamit


#37

Update;

I was checked by a physical therapist today, he told me that he could not pin point what was wrong with me, but had I few ideas.

  1. He believes that the pain coming from my ischial tuberosity could be hamstring related, he had a client with similar pain and this ended up being the problem.

  2. He does not believe that it is PN or PNE due to the fact that he pressed pretty hard on different areas of the lumbar spine which he said should have caused the symptoms to flare up, since they did not, he thinks that PN is unlikely.

  3. I asked him if I could have ischial bursitis, to which he replied probably not because he has never heard of this radiating pain to the penile area. That being said he thinks that my problems may be unrelated, that is to say my pain in the ischial tuberosity and my penile pain are being caused by two different things. I tend to disagree.

  4. His final suggestion was for me to schedule a visit with a urologist and have a pelvic MRI done.

All in all the visit did not give me much clarity, as you can probably tell. My pain is a little better, but I really expected to be a lot better by now. He did say that my pelvis is tight and I needed to stretch my hip flexors.

I do not know whether to go a spend money to see a urologist and get a MRI or not.

Any advice is appreciated.

God Bless,
bamit


#38

It’s always a good idea to double check with a urologist on issues with the pelvis. If they can’t find anything on the first visit, it’s usually not a urological issue (so I wouldn’t keep going back expecting them to find something new).

MRI could be useful as well in ruling out other issues.

My money is still that this is pelvic floor tightness.


#39

I’ve gotten a certain amount of relief from a prostate seat cushion. If you’re interested PM me for the model.


#40

I know this thread is really old, and not sure if you’re still on here, but I was hoping to ask you a question. I’ve been having pelvic pain for about four months now - mainly burning around the penis, scrotum, and tailbone areas. Sometimes it’s a cool sensation, but predominately burning.

Been to a few urologists, they determined my prostate had no bacteria. Ended up referred to a pelvic floor therapist who specialized in biofeedback and corrective exercise. She corrected my sacro-iliac joint and the pain nearly went away for two weeks, but then came back again after my hips went out of place and I recorrected them.

So my question: how long did it take for the Active Release Therapy to work for you?

I just had my first session of ART yesterday. He’s working on my iliopsoas muscle - looks like it’s probably my genitofemoral nerve that’s bothering me. Didn’t feel too different after the first session. My pain is not bad in the morning, when my session was, so it was hard to tell an immediate difference. When my pain came on later that day, it was mostly a cool feeling for a few hours, so that tells me something definitely changed nerve-wise. The cool sensation seems like a half-way point between no pain and having the burning pain.

My chiropractor who uses ART says I’ll see a difference in 2-3 sessions. After the first, I’m not noticing any durable changes yet, but I’m certainly going to stick with it. Wondering if most people don’t notice much after just the first time.