Pudendal Neuralgia
Posted By:
Dr. Michael Coyle, DO FACOOG, FPMRS
Pudendal neuragial is a painful condition involving the nerve that extends from the perineum, or the area located between the genitals and the anus, through the pelvic region and up to the lower back. Pudendal nerve pain often occurs when this nerve is traumatized and then becomes irritated.
The Nerve of It All
Some of the most common pudendal neuralgia symptoms include:
- Pelvic pain in the form of a burning sensation, shooting pain, itching, or rawness
- Pain when sitting
- Irritation of the bladder or bowel
- Pain in the urethra, perineum, or vulva
- Pain in the lower extremities including the legs, feet, and buttocks
- Dysfunctions of the bladder or the bowel, such as defecatory dysfunction
- Sexual dysfunction
What’s Irritating You?
Unfortunately, there is no single specific cause of pudendal neuralgia, which makes it difficult to diagnose. Generally, pudendal neuralgia causes include:
- Trauma to the nerve during childbirth
- Poor posture
- Stress
- A history of trauma to the pelvic area or perineum
- An excessive amount of physical exercise, especially cycling
- Straining
- Pelvic surgery, such as pelvic reconstruction surgery or hysterectomy
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Symptoms should be discussed with a specialist, who will then perform a physical examination of the area and may wish to investigate further by ordering an MRI or ultrasound.
Once they are diagnosed, most patients are given pudendal neuralgia treatment options which include:
- Pudendal neuralgia exercises, which are any form of exercise that will help improve the range of motion to the muscles affected. These exercises often include toe touches, side leg lifts, and supine leg lifts, all of which work to lengthen the muscles. For patients experiencing pain in the buttocks, pulling the knee toward the chest while lying on their side may help relieve the muscle tension. It is not recommend that Kegels exercise be used in cases of pudendal neuralgia, as it will only exacerbate the issue.
- Lifestyle changes
- Medications such as topical agents to numb the pain, antidepressants, and anticonvulsants
- Injection of a nerve-blocking agent such as a local anesthetic or a slow-release steroid
- Use of a spinal cord stimulation system
- Pelvic floor physical therapy
- Nerve decompression therapy
Don’t take pain sitting down! Call the experienced team of healthcare experts at Coyle Institute today!