Pudendal neuralgia(PN) is a form of chronic pain in the pelvic region. It comes from irritation or damage of the pudendal nerve. The nerve is among the primary nerves in the body.
It Supplies the Following Regions:
- The lower part of the buttocks
- The region between the genitals and the buttocks
- The rectum
- The vulva and clitoris in the women and scrotum and penis in the males
The condition is uncomfortable and distressing, but there are available treatments when one seeks medical advice.
Overview of The Symptoms
The key symptom of PN is pain in one of the areas that the pudendal nerve or any of its branches supply. The other symptoms witnessed can be felt quickly or develop gradually over a period.
The pain increases as time goes by and it exaggerates when one sits. The pain is felt in either of the sides occupied by the nerve.
The skin in the affected areas such as urethra, rectum and the genital parts has a hypersensitive reaction once touched.
Pelvic pain- It affects any of the areas affected by the condition.
The pain may take several forms such as;
- Burning or prickling sensation
- It can be sudden or gradual
- It can be worse or better in various instances
- It is majorly felt while sitting but lessens if one stands or lies down
Other Symptoms Comprise;
- Lack of nervous detection and a feeling of pins in the pelvic region
- High irritability- a light touch or putting on clothes feels uncomfortable
- The urge to visit the toilet frequently
- Erectile dysfunction
- Painful sex and problems reaching orgasm
- Feeling of a swelling in the rectum or vagina
- Constipation or problems passing out bowel
- Abnormal temperature changes in the body
- Burning during the process of urinating
- Pain after achieving orgasm
- Pain when the pudendal nerve is compressed on the vagina or rectum
- Uncomfortable feeling with tight pants
- Difficulty in detecting the feeling of urine as it passes the urethra
- Feeling the need to pass out urine even when the bladder is empty
- Back pain which originates from the pelvic area.
Pudendal neuralgia may cause musculoskeletal pain in other Pelvic parts. PN and pelvic floor dysfunction are hard to distinguish as they occasionally occur together. However, the latter involves tense muscles in the pelvic floor for the neural and muscular components.
Causes of Pudendal Neuralgia
Contraction of the muscles and tissues that compress the pudendal nerve- The condition is referred to as nerve entrapment. Pain develops slowly and can be assumed at first. However, a prickling sensation follows.
Frequent cycling, sitting, constipation, and riding of a horse- These activities cause slow but grave damage to the pelvic region.
Games involving continuous hip movement such as weight lifting may result in the straining of ligaments and muscles that are present around the nerve.
Most young runners have a bone that extends to the pelvic region near the pudendal nerve. Cycling is a risk factor that leads to the occurrence of the condition.
Earlier surgery in the pelvic region- The surgery causes pain that sometimes results in a tilted pelvis. Others experience a feeling like that of electric shock. If one maintained the same position for a long time during surgery, the nerve could suffer stretch injury thus causing PN.
Breakage or dislocation of some bones in the pelvic region- Retractors and sutures that are misplaced may cause a direct trauma to the pudendal nerve. PN occurs even in instances when the nerve is not directly touched.
Complications during child birth- Damage of the pudendal nerve may happen during delivery but later improves. In some cases, the pain doesn’t disappear, and the women may grow scarring if there is endometriosis on the nerve.
Growth of a tumor (cancerous or non-cancerous) that presses on the pudendal nerve.
Tests Conducted On PN
Once you detect the listed symptoms for PN, it is advisable to visit the hospital or contact your doctor for further tests to ascertain the condition.
Some of The Tests Conducted Include;
A rectal/vaginal exam- In this test, the physician applies pressure to the pudendal nerve using their finger to establish whether there is pain detected.
Magnetic Resonance Imaging Scan (MRI)- The scan aims at establishing the presence of problems such as pudendal nerve compression and eliminates other potential causes of the pain.
Studies on the nerves- The doctor uses a small device and inserts it into the rectum to establish the functioning of the nerves. The gadget has mild some electrical impulse to stimulate the nerves in the region.
Injections- The area around the pudendal nerves is injected using some painkiller medication to establish whether the pain lessens or remains constant.
Having conducted the tests, the physician is in a better position to determine the action to take and the proper medication to give.
Treatments for PN
Avoidance of activities that worsen the pain the pelvic region, e.g., cycling, constipation, or long hours of sitting. One can use a cushion when sitting to reduce the pain.
Medications- Special medications are given to the patients for relieving the nerve pain.
Physiotherapy- A physiotherapist trains the patients on various exercises that help to relax the pelvic and other muscles that may irritate the pudendal nerve.
Injections for pain-killing- The patients get anesthetics and steroids to relieve the pain for some time.
Surgery- The doctor may decide to conduct a surgery for decompression. The operation aims at removing something that is pressing the nerve to help in reducing the pain.
Stimulant- A particular device is implanted in the patient’s skin to provide electrical impulses to the pudendal nerve and prevent the sending of pain signals to the brain.
PN is a distressing condition, and if one detects any symptoms, it is important to contact a physician immediately. Pudendal neuralgia can get worse if it is not treated.
Early treatment and medication are recommended for pain prevention. Living with the condition can cause stress and have adverse effects on the physical and mental condition of the patient.
Some doctors have records of PN running in families, and they recommend early tests to detect its presence. In some cases, there are no known causes, and the signs are not visible.