Pudendal Neuralgia and Chronic Pelvic Pain

Pudendal Neuralgia

This condition is caused by irritation or compression of the pudendal nerve, which supplies sensation to the pelvic region. It can result from prolonged sitting, pelvic trauma, childbirth, surgery, or nerve entrapment. Left untreated, pudendal neuralgia can significantly impact daily activities and quality of life. Its most common symptoms are:

• Burning or stabbing pain in the perineum, genitals, or rectal area
• Numbness, tingling, or increased sensitivity in the pelvic region
• Pain while sitting
• Worsened symptoms with movement or activity

Chronic Pelvic Pain

Pelvic floor dysfunction can occur when the muscles of the pelvic floor become weak, tight or imbalanced. Pelvic pain may be derived from the pelvic floor muscles themselves, or as a result of nearby structural or functional issues including:

• Lumbar disc tears
• Sacral cysts
• Nerve entrapments from tight pelvic muscles or scar tissue
• Abdominal myofascial pain
• Sacral or pubic bone laxity / instability
• Hip labrum tears / impingement

There are many factors to consider when approaching chronic pelvic pain:

• Structural / physical—traumatic falls impacting the pelvis or low back, chronic gut issues, prior abdominal or pelvic surgeries, difficult pregnancy or labor, endometriosis, history of recurrent urinary tract infections, chronic constipation, hemorrhoids.
• Neurological—central mediated pain or central desensitization, peripheral nerve dysfunction.
• Psychosocial—chronic stress response, anxiety, depression, emotional or childhood traumas, poor communication or disharmony in a relationship.

It’s crucial to receive a comprehensive diagnostic work-up with imaging of the pelvis, lumbar spine, and hips, as indicated.