What is the pudendal nerve?
Pudendal neuralgia is a condition which causes nerve pain in the pelvic region. The pudendal nerve is the nerve that is impacted in this condition, and it controls sensation and movement of the pelvic floor. It also has an autonomic function, meaning that it responds to stress in the body as well. The pudendal nerve also controls contraction and release of the anal and urethral sphincters, which allow for bowel and bladder continence.
The pudendal nerve exits the sacrum and travels through the pudendal canal to innervate the muscles of the pelvic floor. This is where it may frequently become compressed. Symptoms of pudendal neuralgia might include consistent burning, itching, or stabbing pain that worsens with sitting for long periods of time or movement, and does not impact sensation.
Bowel and bladder dysfunction with pudendal neuralgia
Depending on the extent of compression, damage to the nerve, or involvement of pelvic floor muscles, symptoms can also include bowel, bladder, or sexual dysfunction. Furthermore, a decrease in blood flow due to an injury can further worsen nerve pain and dysfunction. Symptoms of urinary or fecal incontinence, urinary or fecal urgency, or urinary frequency may occur with this condition due to a compression of the nerve and involvement of the pelvic floor muscles. It’s important to know that symptoms of pudendal neuralgia have a solution, and you don’t have to work your life around the discomfort and pain!
How does pudendal neuralgia get diagnosed?
Pudendal neuralgia is diagnosed with a physical assessment and through understanding what your symptoms look like. In physical therapy, we work together with your physician to diagnose your condition. A diagnosis can be helpful in understanding how to treat the condition. However, in physical therapy, we understand that the pelvis works as a system, and there may be a myriad of factors contributing to your symptoms.
What does pelvic floor physical therapy for pudendal neuralgia look like?
A physical therapy evaluation of pudendal neuralgia consists of a thorough assessment of your pelvic floor muscles. To learn more about what a pelvic floor assessment looks like, you can read this blog post here. Because the pelvic floor muscles work in a system with other muscles that attach to the pelvis, to assess the extent of the nerve compression and other factors that may be contributing to your symptoms, your physical therapist will also perform a targeted assessment of your low back, hips, and spine.
Research finds that often, hypertonic or overactive muscles can cause or contribute to symptoms of pudendal. When pelvic floor muscles are hypertonic, they have a hard time contracting or moving appropriately. The pelvic floor may become overactive or hypertonic for several reasons: if the surrounding muscles are weak, if mobility is restricted, if there is a history of low back or hip pain to name a few. Understanding the pelvis as a system can help us treat the symptoms you are experiencing.
In physical therapy, treatment may look like education of lifestyle modifications, movement retraining, targeted exercises to improve strength or mobility, and even nervous system education and retraining. Physical therapy can help you reduce pain and discomfort and return to activities you love! If you are curious whether pelvic floor physical therapy can help reduce or resolve symptoms of pudendal neuralgia, you can read more about our services at this link here or schedule a phone consultation at this link here with a physical therapist at Kaya.
