Pudendal neuralgia, is irritation of the nerve that stems from the sacral area (S2-S4). This nerve provides sensory to a part of the rectum, perineum, labia, urethra, vagina, and clitoris. The pudendal nerve is also responsible for controlling the external anal sphincter, bladder sphincter, and pelvic floor muscles.
Symptoms of pudendal neuralgia can include pain with sitting or wearing tight clothing, pain with sex, bladder and/or bowel problems,pain or spasm post orgasm, pelvic floor muscles spasms, and odd sensations including burning, itching, and coolness which may extend to the abdomen, buttocks, groin, and/or legs. Some people experience relief with standing or sitting on the toilet.
Pudendal neuralgia is defined as irritation of the pudendal nerve. If you were to sit on a bicycle seat, the area where you feel the seat is where the pudendal nerve runs on each side. The pudendal nerve can be irritated by being compressed by surrounding muscles, surgery, childbirth, or trauma.
Your physical therapist will perform a thorough evaluation to assess your symptoms and identify the cause of irritation. Being the evaluation will be internal and external, you and your therapist will work together to ensure your comfort throughout the entire process. If your therapist feels you may need further examination or testing, she will refer you to an MD.
Treatment for pudendal neuralgia will consist of releasing the muscle spasms throughout the pelvic floor musculature through various exercises and gentle manual techniques and relieving pressure on the nerve. Your therapist and you will also discuss home exercises and strategies to reduce your pain and discomfort.