What is Pudendal Neuralgia?
Pudendal Neuralgia (PN) is a condition where there is pain or irritation along the distribution of the pudendal nerve. The pudendal nerve provides sensation and motor control to the muscles around the perineum.
Pudendal Neuralgia Causes
Pudendal Neuralgia can be caused by:
- *prolonged sitting activities (bike riding, horseback riding)
- *prolonged constipation
- *childbirth
- *squatting exercises
- *post surgical procedures (hysterectomy, pelvic reconstruction)
- *chronic infections (yeast infections, bacterial prostatitis, bladder infections).
Pudendal Neuralgia Symtoms
- *Burning, sharp, shooting, stabbing type pain
- *Pain with sitting (which eases when sitting on a toilet)
- *Pain with prolonged standing
- *Vagina, labial, scrotal, penile, and/or anal itching, burning, or numbness
- *Clothing intolerance
- *Rectal/ vaginal Pressure (feeling of a pressure or an object in the rectum/vagina)
- *Urinary frequency/urgency
- *Urinary hesitation
- *Pain during and after a bowel movement
- *Constipation
- *Decreased sexual function
What is Pudendal Nerve Entrapment?
Pudendal Nerve Entrapment (PNE) differs from PN because the pudendal nerve is constricted or distorted within a fibrous band or tunnel. The most common areas of entrapment occur in structures around the pelvis or sacroiliac joint, a certain tunnel in the pelvis (Alcock’s canal) or around the base of the penis.
Pudendal Neuralgia and the Pelvic Floor
With both PN and PNE, there is often a correlation with an overactive pelvic floor. The pudendal neuralgia or entrapment and pelvic floor dysfunction may co-exist. In other words, one may lead to the other; there may be an overlap of the characteristic pain. One type of pain may be more intense than the other. All of this adds to a complication with diagnosis and treatment.
Pudendal Neuralgia Treatment
Treatment of PN and PNE can be complicated because of the slow healing nature of nerves. Treatments often include medications aimed at neuropathic pain and physical therapy to address pelvic floor dysfunction which can be a cause of PN and PNE. Physical therapy treatment will be aimed at releasing tightened tissues in and around the pelvic region to improve the nerves ability to glide and heal.
