Pudendal Neuralgia

What it is

Pudendal neuralgia is an entrapment of the pudendal nerve that can cause pain, numbness, tingling, burning, and/or itching in the pelvis or genitals. It is similar to carpal tunnel syndrome (median nerve entrapment), though in the pelvis.

Side view of male pelvis to show path of pudendal nerve
Image by: Häggström, Mikael

How it is treated with physical therapy

If the nerve is compressed by muscle spasms and tension, therapist can work directly on the involved muscles to release the tension and decrease pressure on the nerve. This work is done both internally with a gloved finger as well externally throughout the hip musculature. This condition responds very well to muscle release with trigger point dry needling.
Therapist will likely work other soft tissue involvement in the abdomen, thighs, or deeper pelvic floor muscles.
If conservative care fails, it is possible that it is a true entrapment involving bone and may require a surgical release.

Your Homework

Therapist will teach you to perform all manual work on your pelvic floor at home. You will also be given relevant stretching and strengthening exercises as needed based on your presentation.
You are welcome to bring in your partner if they would like to learn how to do what I do in order to help you progress quicker with a home program. The long term goal is for you to feel in control of your pain. When you own it, it no longer owns you!

How many sessions

Your treatment can go on until you feel independent with working on your pelvic floor on your own. This varies widely from patient to patient. I have seen patients for as few as 3 visits, and for as many as 30.
I typically like to see this patient once per week so the muscle tension is less likely to return between sessions.

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