What is Pudendal Neuralgia?

Marjorie McAtee
Marjorie McAtee
Direct impacts to the coccyx bone may be a cause of pudendal neuralgia.
Direct impacts to the coccyx bone may be a cause of pudendal neuralgia.

Pudendal neuralgia is a chronic pain condition that affects the pelvic floor. Pain may occur in the genitals, perineum, and anus. Pain typically worsens throughout the day, especially with sitting. Pudendal neuralgia usually occurs with compression, rubbing, or stretching of the pudendal nerve. A number of conditions can cause symptoms similar to those of pudendal neuralgia, so this condition is normally diagnosed by process of elimination. Treatment may involve steroid or other injections, surgery, and prescription drugs.

Pudendal neuralgia may occur as the result of nerve damage caused by childbirth.
Pudendal neuralgia may occur as the result of nerve damage caused by childbirth.

The chronic pain disorder known as pudendal neuralgia often occurs as the result of nerve damage caused by frequent cycling or squatting exercises, childbirth, surgery in the pelvic area, or structural problems with the pelvic floor or sacroiliac joint. Other causes of this condition include chronic constipation, recurrent vaginal infections, and direct impacts to the coccyx. Symptoms can include tingling, burning or stabbing sensations, numbness, cold or twisting sensations in the genitals, anus, and perineum. Men and women may have the sensation of a foreign object trapped inside the anus or vagina, and pain and discomfort may occur on one or both sides of the pelvic floor.

Pudendal nerve damage may cause bowel movement difficulty.
Pudendal nerve damage may cause bowel movement difficulty.

Patients suffering from pudendal neuralgia may experience no discomfort upon waking, however, discomfort typically increases throughout the day, especially when patients sit upright. Sitting on a donut-shaped pillow, or lying down, can relieve pain and discomfort.

Pudendal neuralgia can cause sexual dysfunction in both genders. Both men and women may experience pain or numbness in the genital area. Women may have problems reaching orgasm. Men may experience painful erections and painful ejaculation. Problems with urination and defecation can also occur, ranging from feelings of constipation and urinary hesitancy to partial or complete fecal and urinary incontinence. Voiding the bowels and bladder may become difficult and painful.

Interstitial cystitis, which is a condition characterized by long-term bladder inflammation, may produce symptoms similar to those of pudendal nerve damage.
Interstitial cystitis, which is a condition characterized by long-term bladder inflammation, may produce symptoms similar to those of pudendal nerve damage.

Diagnosing pudendal neuralgia is often a matter of ruling out other possible causes for these symptoms. Conditions such as vestibulitis, pelvic congestion, interstitial cystitis, or coccygodynia can produce symptoms similar to those of pudendal nerve damage. Once a diagnosis is made, treatment can vary depending on the cause of nerve damage or entrapment.

Patients suffering from pudendal neuralgia may experience problems with urination.
Patients suffering from pudendal neuralgia may experience problems with urination.

Steroid injections administered to the pudendal nerve are often used to treat pudendal neuralgia. Steroids can help ease inflammation, allowing the nerve to heal. In may cases, a series of two to three such injections can resolve the chronic pain problem.

Anti-depressant drugs or anti-seizure medications may also be administered during treatment. For some patients, surgical decompression of the pudendal nerve may be a more effective treatment. Surgery is believed to be successful in about 60 percent of cases.

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Discussion Comments

anon287986

Who do I turn to with that kind of pain in the rectum? Proctologist? Neurologist? Orthopedist?

Thanks.

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    • Direct impacts to the coccyx bone may be a cause of pudendal neuralgia.
      By: photoBeard
      Direct impacts to the coccyx bone may be a cause of pudendal neuralgia.
    • Pudendal neuralgia may occur as the result of nerve damage caused by childbirth.
      By: Olesia Bilkei
      Pudendal neuralgia may occur as the result of nerve damage caused by childbirth.
    • Pudendal nerve damage may cause bowel movement difficulty.
      By: Remistudio
      Pudendal nerve damage may cause bowel movement difficulty.
    • Interstitial cystitis, which is a condition characterized by long-term bladder inflammation, may produce symptoms similar to those of pudendal nerve damage.
      By: 7activestudio
      Interstitial cystitis, which is a condition characterized by long-term bladder inflammation, may produce symptoms similar to those of pudendal nerve damage.
    • Patients suffering from pudendal neuralgia may experience problems with urination.
      By: eyeQ
      Patients suffering from pudendal neuralgia may experience problems with urination.
    • Anti-depressants may also be used to treat pudendal neuralgia.
      By: Alliance
      Anti-depressants may also be used to treat pudendal neuralgia.