Physical Therapy For Treating Pudendal Nerve Entrapment
Nerve entrapment can be profoundly uncomfortable, causing pain, weakness, numbness, tingling, ‘electric shock’ sensations and multiple other issues depending on the affected nerve. The Pudendal Nerve is the main nerve of the perineum, located between the anus and genitals, and when entrapped can cause not only discomfort but issues affecting the pelvic organs, sexual, bowel and urinary health.
Although both men and women can experience Pudendal Nerve Entrapment (PNE), it is more common in women. If you are female and are experiencing any pain or problems in the pelvic region, then we recommend being assessed by Sylvie, our dedicated Women’s Health Physical Therapist.
Common causes of PNE are childbirth, exercise –– particularly cycling, surgery, falls, biomechanical dysfunction, and sitting for prolonged periods.
However, it may not be obvious what the cause of your PNE is. Pudendal Neuralgia is a rare but closely related condition, whereby the symptoms of PNE are experienced although the Pudendal Nerve may not appear to be entrapped.
The Pudendal Nerve has a right and left side branch, running from the back of the pelvis to the genitals, and because it passes through various narrow pelvic structures this leaves it vulnerable to entrapment. The discomfort caused by PNE can be experienced on one or both sides of the pelvic region, and affects the genitals, rectum, the pelvic floor and glute muscles.
Symptoms of PNE include pain, burning sensations, and numbness anywhere in the genitals, anus, or perineum.
Often the sensations are experienced when sitting, but relieved when standing or lying down. Other symptoms are urinary issues, such as pain, hesitancy, increased frequency, or urge; painful bowel movements; and sexual dysfunction such as painful intercourse. As PNE is a neurological condition, it can manifest as a highly sensitized nervous system, causing you to experience pelvic pain from sensory stimuli, particularly physical stimulus, that wouldn’t usually cause pain or discomfort.
Diagnosis & Treatment:
To diagnose PNE your Physical Therapist will take a detailed account of your symptoms and assess the biomechanical and physical structures that can cause PNE. They will also eliminate any other conditions that present with pelvic, lower back or genital pain. Although an MD can perform tests for PNE or nerve damage, PNE, and particularly Pudendal Neuralgia are notoriously challenging to diagnose, therefore if you suspect PNE we recommend being assessed by a Physical Therapist.
Physical Therapy is clinically proven to be highly effective for treating PNE. Your treatment plan will be personalized depending on your PNE symptoms and any other comorbid conditions. It will consist of manual treatment, particularly targeting the pelvic floor muscles and any other fascial or musculoskeletal trigger points, as well as exercises to retrain the body into healthier movement patterns. Neurological conditions also benefit from balancing the nervous system, something yoga, mindfulness and breathing exercises are excellent for. As Sylvie is also a Yoga Therapist she may recommend some of these exercises.