Thank you for this Informative Video. Fascinating actually. I suffer with an affliction which is affecting my rectum. Bowel / Bladder urgencies and Incontinence. I have an Overactive Bladder (per my Urologist) with some BPH of the prostate. Moreover, I have S1-L5 Spondylolisthesis, Spondylosis of the Lumbar, Thoracic and Cervical Spine. Mild to Moderate stenosis at various sites and Lumbar Dextroscoliosis at 25 degrees stemming from a 1" shorter right leg. I'm a 72 YO, Male. I fractured the Femur in 1966 playing HS Football. The LLD was left unaddressed for decades and after about 20 years late - age 36 - the lower back stiffness and discomfort from bending over (Like Vacuuming) was setting in. The SI joints have been chronically Inflamed. My Neurologist told me that many Back Problems start at the SI Joints as "Ground Zero" for back problems. The issues traverse up the spine all the way to C1 - like me. 48 Years of driving / commuting to & from work /home at least 3 hours (or more with NY Traffic) has taken a Major Toll on my spine (not just my Wallet!). I get Saddle Anesthesia on & off for a few years. Cauda Equina was Ruled OUT. It's a Piriformis issue for sure. My GI NP, just conducted a rectum exam with electrode probs to measure the holding and pushing strength in the rectum. She has recommended Pelvic Floor PT. Would this be a pudendal Neuralgia situation too?
When you say "Pudendal neuralgia is a mechanical condition" it is the most validating thing....as though years of gas lighting falls away. I know this to be true and the few PTs who have helped me with PN treated me for mechanical issues which brought me relief...but I had to travel out of town for this, and in trying other local PTs so many are misinformed and just presume a central nervous system problem and encourage me to load the nerve more or to tighten which causes worsening...even though I respond to local manual therapy (and local medical therapy for my bladder inflammation condition--primary driver caused the PN). I have to work so hard to convince them it is a mechanical condition :( . Your book and videos are such a huge help.
It is a condition that has a lot of information (good and bad) out there! Pudendal neuralgia can be tricky when you don't fully understand the scope of it (as a provider). We are glad that our videos/book has been helpful and validating to you. You can also subscribe to our blog for more evidence based information pelvicpainrehab.com/category/female-pelvic-pain/female-pudendal-neuralgia/
i have PNE from pro cycling since 2005 . I have taken all meds and tryed all exercises and theraphy . I found the perfect combination of meds which i take every day and live a pain free life. 1. TRILEPTAL 300 MG ( anticonvulsinant) 2. XANAX 0.5 MG ( ansiolitic) take 300 mg trileptal plus 0.5 mg xanax 7 am. 11 am 3 pm and 7 pm. lots of water. very loose underware and pants. use a palvic floor seat cushion always! have a happy life.
@@PelvicHealth Apart from the meds every morning its important to stetch the pelvic flor and lower back . it is a very frustrating condition and the best solution is combining these meds with the exercices ...also sometimes its important to take muscle relaxing meds ..the best is called MELOXICAM 15 mg. the anal obturator muscle has to be relaxed , otherwise it will cause pressure on the nerve and a burning sensation. its also good to use some vaseline to lubricate the anus when going to the bathroom , and use talc in the perineal area and between the legs so the underware wont rub against the skin . this pinching needle feeling in the skin is calked alodimia , and with talc it will calm down . I am not a fan of the surgery , only 10% of people feel some relief after 2 years , some can even feel worse. Do not do accupunture . Do not do electric theraphy. You matress has to be very soft , not hard or orthopedic , it will hurt more the nerve. Use very soft and confortable tennis or running shoes..the pudendal nerve has roots that end in the feet and hard shoes are not a good idea.
@@eduardonessim4499 thank you again for your comment! Everyone reacts differently to medication, so it's great to have other share their experiences in case others might benefit to something similar. Additionally we could not agree more with you about stretching your pelvic floor and stretching in general.
This video is very useful, thank you. It’s for the first time when I hear about a connection between walking barefoot and pudendal neuropathy. I walked barefoot all my life inside my house and because I mainly work from home that’s actually most of the time. I would find extremely weird to wear shoes inside the house but I’ll try. Would some slippers with thick soft sole do, instead of sport shoes?… so I can take them off easily when I lay down.
This is a great idea for future discussion. Surgery recovery is a big topic. Recovery will vary, so it's useful to have a physical therapist to guide you through it. It will likely include a gradual return to sitting and activities that aggravated your symptoms. Be patient, because the full recovery can take many months. Check out this video for some more information about the surgery. ruclips.net/video/JrfHKVlpb1A/видео.html
Hi Pooja, yes it is possible to have PN without urinary or bowel involvement. Some people with PN only have altered sensations or nerve pain in the distribution of the nerve. While the nerve innervates part of the urethra and the anal sphincter not everyone has symptoms in these areas, teh symptoms depend on which nerve branches are affected and how involved the pelvic floor muscles are.
Thank you for this video. I gave birth 3 months ago and have had really sharp pain. Everything you said are the exact symptoms I’ve been documenting. You mentioned avoiding certain exercises or movements. Is this something we need to do indefinitely or will the nerve heal? I can’t imagine living with this pain forever. 😓
Limiting the movements and exercises is meant to reduce stress on the nerve and surrounding tissues to support the healing process. Everyone's process is a little different, but yes, the idea is to be able to gradually incorporate those activities in the future.
Hi, hope you could answer a question: I know this might be silly but is it possible that pelvic tension/pain can shift from one place to another? say from rectal to prostrate, or from urethral to pubic? Not sure if this is weird but this has been occurring for me every few hours.
Hi Aditya, this is not a weird question at all, and symptoms can move between all of the areas you mentioned. The pelvic floor muscles attach at the pubic bone anteriorly and the coccyx posteriorly. In addition the pudendal nerve innervates the majority of the pelvic floor muscles, the genitals, the anus, and part of the urethra and rectum. For these reasons and connections symptoms can occur in any of these locations.
@@PelvicHealth can a person feel like something is biting in rectum and vagina at sudden in pudendal neuralgia. My mother is suffering from all you mentioned symptoms plus this from more than 8 years after hysterectomy. Please reply, what is this
@@bhartiyaveerangna9412 Hello, without a full examination and talking to her, we cannot advise exactly what it is. We highly recommend she see a pelvic floor PT to evaluate her pelvic health.
This is incredibly useful information. Thank you for sharing! I’m not yet diagnosed with PN but the more I know about it, the more I’m sure that’s what’s happening to my body these last 3 years. I was diagnosed with vulvodynia, had a full vestibulectomy and got even worse. I think that my symptoms fit perfectly with PN but I can’t understand why I get my burning sensation on the vulva to go from a 10 to a 2 as soon as my menstruation starts. That’s what puzzles me… Do you have have idea of why that might happen?
Thank you so much for sharing and great question. It definitely seems like something in relation to a hormonal shift since you notice a change during your menses. We would recommend seeing a doctor to rule out yeast or BV. pH changes once menses starts and yeast infection type symptoms sometimes actually improve during that time. PN wouldn’t typically behave this way. Seeing a sex med specialist would be a good step and if you haven't seen a pelvic floor PT as well that would be beneficial. Hope this was helpful!
We would advise seeing a pelvic floor PT who can evaluate your pelvic floor and take into consideration your symptoms. Without an evaluation, we could not say what the best thing is to you, as we would need more information.
Hi . Iv had a raw feeling in my vulva which is red too. It’s not a pain as such but feels very raw . Iv tried many lotions and creams but vagisil is the only one that gives my some relief . Please help me . Thank you. X
Thank you for sharing with us and you are not alone. This sounds like a referral to a gynecologist for an evaluation would be a first step. They can rule out any infection that can be occurring. Then seeing a pelvic floor physical therapist may be a next step as well. Also, here is a blog post that goes over different diagnoses that may be involved with the symptoms you are describing. pelvicpainrehab.com/female-pelvic-pain/vulvodynia-female-pelvic-pain/5458/ten-[…]eed-to-know-about-vulvodynia-vestibulodynia-and-vaginismus/ Hope this is helpful!
@@rstein3131 yes I went to gynaecologist. She said I have lichen planus. Could have it for life. Steroid cream & wash cream . Look it up on utube. You can have it anywhere on your body . Mine is the vulva. I’m nearly 75 years old. Hopefully it goes away 🤞
Had a very difficult childbirth in 1974 and was immediately unable to sit for over a few minutes without burning. After 11 months and extremely painful steroid shots in the region, the docs decided I must had broken my coccyx during the birth and I should have it removed. I had the surgery but nothing changed with the burning. That was in 1974. Just recently I discovered the term "pudendal neuralgia" and am trying to find a doc who works on this. I've told doctors about this burning when I sit or lie on my back since the birth, and most think I'm a hypochondriac. I was diagnosed with fibromyalgia in 1993 and just recently diagnosed with small fiber neuropathy. I do not have diabetes, am not obese. ??
Burning pain with sitting or lying on your back can be a symptom of pudendal neuralgia. You are welcome to schedule a digital health appointment with us to discuss your case. The International Pelvic Pain Society website may help you find a doctor who is familiar with this type of pain.
We cannot make a diagnosis without an evaluation. Please check out our blog for more resources + info about Pudendal Neuralgia pelvicpainrehab.com/male-pelvic-pain/male-pudendal-neuralgia/16225/pudendal-neuralgia-resources-updated/
Severe pain may cause blood pressure changes which can lead to lightheadedness. If the pain is coming from a peripheral nerve or muscle it should not cause fever and low blood sugar. PN does not typically cause pain in the arms and can be associated with pain in the legs.
Thanks for asking! Sometimes this can occur when the pelvic floor muscles aren't functioning as they should. In some cases, the muscles are too restricted that it makes it hard to control gas, or the muscle may be too lax and weak which can allow gas to sneak out. Sometimes this may occur as a direct result of pudendal nerve entrapment when the nerve is unable to send signals like it is used to. In other cases, it is due to purely muscle function which may be a secondary finding. Here are great blog posts about entrapment versus neuralgia which may help to answer your question more: pelvicpainrehab.com/male-pelvic-pain/male-pudendal-neuralgia/726/how-do-i-know-if-i-have-pudendalneuralgia-or-pudendalnerveentrapment/ pelvicpainrehab.com/male-pelvic-pain/male-pudendal-neuralgia/16132/ig-live-q-a-pudendal-neuralgia-pudendal-nerve-entrapment/
Hi,it’s been 45days i had a Endoscopic disk surgery, Now i am pain free but before my operation and now on while i am sitting motorcycle or riding motorcycle my penis got numbness like pins and needle sensational feeling, why this is happening and what should i do? Hope u will be helpful for me
Hello, We recommend you see a pelvic floor PT to address the pelvic pain you are experiencing. We wouldn't be able to say one way or another what your pain is or where it is coming from (if it's related to the pudendal nerve), without physical evaluating you. We recommend finding a PT to evaluate you and your pain.
I am male and after sitting on a hard chair to do some computer work I noticed a tension in the perineal area. A misdiagnosis of prostatitis first then the dr came to the conclusion I had Pudendal nerve damage. I was put on Gabapentin and codeine. 18 months later and things are just getting slowly worse. I have had no relief whatsoever and these pills are slowly killing my mind. I walked out in front of heavy traffic last week, I didn’t even know where I was going! Ive forgotten how to play the guitar, I can’t ride my bicycle or motorcycle anymore and to travel by car I have to wedge 2 thick wooden blocks underneath my upper thighs to keep my perineum from touching base. Looks like I’ll be living with this. Here in the UK unless you are very wealthy, there is no recourse to any facility or neurological help whatsoever.
You are always welcome to schedule a virtual consult with us if you would like to review your case and see if there is anything we can help with. pelvicpainrehab.com/telehealth/
Hey man. I am suffering with Pudendal Neuralgia too. This is my second time experiencing it. First time was in 2017, it last about 8 months. This time I have been suffering with it since early June, so about 6 months. I am just checking in to see how you are doing? I was put on Lyrica, nerve pain meds the first time and they messed my mind up too. I had to get off them. I hope you are okay my friend. It has been 3 months since you wrote this comment, how are things now? I am holding onto hope that I beat this the first time around so I can do it again.
@@KJ-pu8dw Hi, the first time I didn't do anything in particular really I just waited it out. It started to improve after 8 months and slowly got better. I just tried to manage it daily by not sitting down for too long. I also stopped having sex completely. Unfortunately this time around I am still suffering with it. I am 9 months into this time with no end in sight. It is a lot worse this than the first time. I have recently started taking Endep so hopefully that works.
There are various ways to lengthen the obturator internus. One can do this with a self stretch or a physical therapist can lengthen the muscle manually within the pelvic floor which they would access via the anus for a male. The pain in the testes should be fully evaluated by a urologist to rule out any testicular pathology. Pain in the testes could also be coming from the spermatic cord which could be irritated. Bringing the knee to your chest would compress the spermatic cord, therefore, if it is already irritated, bringing the leg towards your chest could further irritate it.
@@PelvicHealth I had a bike accident broke got Crack in ishial spine on right and sit bone of left and it hurts left testis to pull left leg towards chest , it hurts burning like throughout the day , comes for seconds even if I don't pull leg to that angel . What to do . Plz help I am afraid . And also got bladder injury . Will I be able to sit pain free . I am on complete bed rest since 2 months. Plz plz help me . And I didn't understand how I can self stretch or how phisiotherapist would do via anus plz plz reply and help. Left testis left side part hurts . I am on catheter got negative infection test also not able to urinate without catheter plz plz plz plz help help help I can't see my parent in pain . Plz give knowledge and solution
@@adityastyles259 I'm sorry you're in so much pain. It is virtually impossible for me to hypothesize what is causing your pain with this information. If you have a pelvic fracture, which is sounds like you do, I think you have to allow that to heal first before pursuing any sort of pelvic physical therapy. Hopefully allowing these injuries to heal with time will reduce your pain.
I had an anal fissure which became chronic but finally healed after 6 months. The fissure is fully healed, as per my colorectal doc. But new pain cropped up, hip & back, deep rectal tightness, inhibited urination and on and off constipation… my CRS diagnosed pelvic floor dysfunction, and thankfully referred me to a pelvic floor PT. PFPT told me a lot of my symptoms are coming from pudendal neuralgia, tight pelvic floor and tight QL, overactive sympathetic nervous system and tight obturator. PFPT is helping but I’ve noticed it’s way worse lately because I’ve had tremendous life stress hitting me all at once. Is this all connected?
That is good news to hear that the PFPT is helping. Stress can absolutely be connected and make some of your pain worse. Do you have ways to manage your stress? Or have you tried any mindful techniques to help work with the pain causes by your stress?
I have trigger points in my muscles and a nervous system dysfunction every once in a while. PN started as a result of long and horrible fights with my SO. Now I am absolutely terrified that this might last long. Does it ever go away?
Thank you for reaching out. The key to treating PN is to make sure you are addressing all musculoskeletal and neuromuscular impairments. Pelvic physical therapy is an important part of this, so we would recommend getting an evaluation by a pelvic physical therapist. We offer virtual appointments here: pelvicpainrehab.com/telehealth/
Hi I fell on the floor 2 years ago on a setting position and after 3 weeks of this accident I developed pain during urination and around vulva it's like burning sensation. only one week ago I discovered that I have pelvic floor prolapse i have a desending pernium and rectocele.can this be the cause of my pudendal neuralgia and why it flare up only when I fell ???thank you 😊 for helping us with alot of helpful information 💁♀️ 😊
Typically pelvic organ prolapse does not cause pain. This includes a rectocele. Pelvic organ prolapse should not compromise your pudendal nerve. Your pain is more likely coming from the pelvic floor muscles and/or the pudendal nerve becoming irritated from the fall onto your buttocks. A fall on one's buttocks is a fairly common mechanism of injury to the pudendal nerve.
@@PelvicHealth Thank you so much for answering so quickly. I am actually from Egypt and the knowledge here about pudendal neuralgia and pudendal nerve entrapment is very limited. I have started physical therapy because my doctor told me that the grade 2 rectocele and grade 2 descending perineal syndrome might have caused the pne because it streched the nerve but the trigger point that caused my symptoms is the fall, is this true? If the pain developed from the muscles like you said do stretching and strengthening exercises help or how should I deal with it. Is the irritation the same as entrapment and if I have irritation what can I do to help cure my symptoms? Finally, what do you think about pudendal nerve decompression surgery? Do you think it can releive my symptoms and cure me? Once again I'm really happy for your help and would like to know any extra information as the information here is very limited
@@alshimaaeleffish3205 I think it is doubtful that the pelvic organ prolapse caused the pudendal neuralgia. I think it is much more likely that the fall caused the pain. The fall may have caused some inflammation around the nerve and/or around the sacrospinous and sacrotuberous ligaments, which the PN runs in between, which could have led to the neuralgia. The muscles surrounding the nerve may have responded to the pain by tightening. Obviously I can't be sure without evaluating you myself. An irritation is not the same as entrapment. I think it is very doubtful that you have entrapment. I would not pursue a nerve decompression surgery before exhausting conservative therapy (physiotherapy) first. A decompression surgery is for pudendal nerve entrapment. A combination of pelvic floor physiotherapy and pharmacotherapy (medications) would likely resolve your pain over a series of months.
@@PelvicHealth thank you so much for replying. It's really hard to find any information here in my country which made me extremely depressed thank you for your help, I will always remember your tremendous helping. I am currently seeing a physiotherapist but she is new to the field and she hadn't really had anyone that has my condition. She started by giving me some strching exercises. Can you help me by telling me about any videos that you recommend especially for the inflammation and what medications I can take for the inflammation. My physiotherapist also wanted to strengthen my muscles because of my rectocele. Can this irritatate the nerve more? Finally some of the exercises she gave me included squats, is this bad for the inflammation. The pain in my vulva comes and goes by itself (without any medication) but pain during urination is constant. When I took antidepressants (SSRI) for 9 months the pain in my vulva went away but the pain in urination stayed and wasn't releived by the SSRI or gabtenin what is this related to and what is the cause of it. Is it the tight muscles around the urethra? My symptoms also become worst before my period but during my period there is no pain except when urinating. Should I do a cystoscopy to look for any cysts? We did an ultrasound but only found tiny nabothian cysts. Finally is endometriosis found on ultrasound or are there any other ways to diagnose it? Because some of her symptoms relate to endometriosis. Can any other cysts cause this kind of pain? Because I sometimes doubt entrapment or normal inflammation because I don't have any rectal symptoms.
@@alshimaaeleffish3205 Since you have multiple questions that really require a little more information for me to answer them comprehensively, I would suggest that you schedule a telehealth appointment with me so we can discuss your questions and I can try to give you as much helpful information as possible. You can schedule a telehealth appointment with me via this link. On that page, click on the icon for the "East Coast" and you can schedule an appointment with "Liz" via that link. pelvicpainrehab.com/telehealth/
Many people are able to walk without issue. But sometimes taking larger steps or walking up hill can be provocative for some. It is always best to work with your pelvic floor PT who can help you come up with strategies!
I’ve been bedridden for about a year and this is one the pudendal neuralgia started. I never hear about being in a lying down position, causing this a pain. The pain is severe whether I stand, sit or lie down. The doctor said that because I will probably be bedridden for another year or more and there is no way I can help my condition.:(
Thank you for sharing your story and we are so sorry to hear what you are going through. Staying in bed is often times not a good solution. Without knowing the details of your case, it is challenging to give you specific advice. We do offer virtual consultation and would be happy to help you formulate a plan. pelvicpainrehab.com/telehealth/
I developed this after having a laparoscopy. It literally feels like someone set my entire pelvis on fire. I’m on gabapentin and going to PT. Scared this is going to last forever.
I'm sorry to hear that you're experiencing symptoms of pudendal neuralgia. I'm glad that you are taking medication and seeing a PT who can help. PN pain does not always last forever! Here is one of our success stories of a patient with PN who recovered under our care. pelvicpainrehab.com/male-pelvic-pain/male-pudendal-neuralgia/6508/recovered-from-pudendal-neuralgia-sheyoumes-success-story/ pelvicpainrehab.com/pudendal-neuralgia-causes-symptoms-treatment/ If your symptoms aren't progressing, it may be worth a telehealth appointment with one of our PTs who specialize in PN. You can book a telehealth appointment here: pelvicpainrehab.com/telehealth/ Good luck with your treatment!
"Sympathetic sensory and motor fibres" mean the nerves that carry messages to and from the brain, respectively. The brain collects information from the whole body and decides what kind of sensation to produce, such as pressure, itch, or pain. Emotional stress of any kind will add into the brain's calculation. You are likely right. Even when neuralgia was triggered by an initial injury that has healed, emotional stress can be the main driver. There are psychologists who specialize in pain to help people in this situation. These books may also help. www.amazon.com/Explain-David-Butler-Lorimer-Moseley/dp/0987342665 www.painpsychologycenter.com/the-way-out/
It can be very hard to determine and you need to work with a skilled team to rule in and out all possible sources of pain. There can be a lot of overlap between the 2 diagnoses. We recommend a virtual consult with us so that we may better help you. pelvicpainrehab.com/telehealth/
Hello! Without seeing you, we cannot advise certain exercises. We recommend checking in with your pelvic floor PT to assess what exercises are most appropriate for you and the state of your pelvic floor.
@@PelvicHealth hello, Yes that would be great but the country I'm in doesn't really have pelvic specialist, So if you really tell me how can I check my pelvic floor as I'm an athlete and I can't stop my workout and other training. Thank you
@@zubairrahman3679 Unfortunately there is not a decent way to explain to someone how to “check” their PFM on their own without some hands on guidance from a clinician. One way, although not a very good way, would be to insert one finger vaginally or rectally, squeeze the PFM/do a Kegel, then observe what happens. Do you feel a good squeeze? If so, does it fully release after you relax the contraction or does it stay contracted for a few seconds after you’ve let go. If this is the case it *could be an indicator that your PFM are too tight. If that’s the case they could use a to try pelviwand to stretch the PFM and/or PF drops and diaphragmatic breathing.
Hi! While we do not have specific stretches from cycling, we do have a few informative blogs about pain from cycling that you might find beneficial! pelvicpainrehab.com/pelvic-pain/6787/as-the-bicycle-turns-cycling-and-the-pelvic-floor/ pelvicpainrehab.com/pelvic-pain/7858/have-a-pain-in-the-a-while-sitting-on-your-bike-saddle-optimize-your-saddle-using-pressure-mapping/ Additionally, we have some yoga (stretching) for PN on our Instagram page, that you should find useful instagram.com/tv/CPn91_MJRra/?
Use special cushions also described in a video of this channel ruclips.net/video/sStY4NbHwP4/видео.html and ruclips.net/video/y24j0nXZ9V0/видео.html and see online for donut or round cushions . And for sleep buy air bed or lie on left side and take alpha lipoic acid (ala) specially and other supplements check on you tube this will help heal
Yes, the pudendal nerve can cause specific burning on one side of the vulva if a specific branch of the pudendal nerve is irritated, likely the perineal branch.
Hello! any feedback would be appreciated - I have dull rectum , perineum, and base of penis pain that fluctuates and is mostly noticeable when having sex and ejaculation seems to make it flare up afterward. I have seen 3 urologists and now doing PF physical therapy but the therapists doesn’t seeemed to be focusing on pudendel neauralgia which my best guess is this is what it is , the sexual dysfunction and pain is very hard to deal with, any further advice
Hello! Without seeing you to consult more about your case, we cannot advise more. If you would like to see us virtually for a consult, we would be happy to help! pelvicpainrehab.com/telehealth/
Hello! Yes absolutely Pudenda Neuralgia can affect erections. If you have PN and need treatment, we recommend seeing a urologist and then possibly incorporating a pelvic floor PT into your care team to address your symptoms.
Yes. Changes in tissues and structures around the pudendal nerve can lead to nerve irritation and pain. A pelvic PT and a good pelvic pain doctor would be helpful in this situation.
I have been dealing with increased sensitivity in the glans of the penis. It looks a bit discolored and it feels scratchy when I’m wearing pants. I’ve been to the doctor and urologist and they say there is nothing wrong with me. Is this a nerve issue or symptoms of nerve issue.
Just lately for me things are getting worse. I now cannot lift my left leg towards me in a standing position ie to put on a shoe or sock? The pain in the adductor longus area is preventing me from doing this movement. I have lift my own leg and hold it now to put footwear on. My right leg is still strong and has full range movement. Would this symptom help in identifying the area of pudendal entrapment for me? Many thanks to you for any reply.
Also forgot to mention, it could be the top of sartorius I’m thinking? Also my gait is very affected lately and some days my feet are excruciatingly painful. I’m not enjoying it at all I tell you!
Sorry to hear that your symptoms are getting worse. It definitely sounds like a myofascial issue and/or pelvic girdle dysfunction. If you have not seen a physical therapist, I highly recommend doing so. They can assess your gait, posture, and pelvis and help identify the cause along with recommending specific stretches or exercises that will help. If there is anything concerning, they will also be able to recommend providers in your area that may be able to provide medical management or further testing if necessary. Often times when joints aren’t moving properly or there are changes in the muscle tension relationships, these types of symptoms occur.
You’re very kind to reply to me, I really appreciate it. Things in the uk have gone from bad to worse lately with regards to even getting a local GP to consult with. Seems they’re just throwing meds at us. Anyway, I will keep trying my luck at getting a response and even maybe a diagnosis. But my sincerest thanks to you again.
A year on and I have just got progressively worse. Both of my greater trochanter muscles are so tender, pushing them in is like an electric shock. It seems there lies the pudendal nerve irritation? I saw a chiropractor/physiotherapist who literally made things even worse. Since he treated (ruined) me, I can’t move my neck from side to side, I have 2 frozen shoulders, also my sacroiliac is so tense and painful. I also now have neuropathy in both feet, I either can’t feel them or they burn like crazy. Could be sciatica I suppose? The drugs I take are basically keeping me numb so I don’t dwell on things any more. Ah well, it could always be worse. I’m still walking and doing some light weights on a bench which helps keep me insane lol 😊
Hey question, So my Pudendal nerve irritation happened 3 months ago due to a horribl session of edging, I abstinated from sex and masturbation for a month and i have immense burning inside my rectum area. I also had masturbated for 3-5x a day. I'm seeing a PT right now, this is my 4th session of internal work where shes pressing on my trigger point for 30 secs and then massaging the muscle around. However I do feel burning intensely, shes saying my Pudendal nerve is irritated, do you know how long it takes for nerves to heal from excessive masturbation or edging? How do i go on about this?
Thank you for your question and so glad to hear you found a pelvic floor physical therapist! A few things to think about would be 1. Does the pain change at all during the session and/or are you getting relief despite having the pain during the treatment? Nerves can be slow to heal, and everyone is slightly different. We have noticed with many male patients it has been helpful to use a bit of “Anecream” (lidocaine cream) as the anal tissue is irritated and this allows for more tolerance to PT when addressing the muscle aspect. Its worth asking! Additionally, it may be worth discussing with your team of providers if a PN block may be helpful in order to better tolerate addressing the muscular portion if that is inhibiting progress.
There absolutely is but it is dependent on the root cause! Often times, people need to work with a multidisciplinary team to address all aspects of their symptoms. You can schedule a virtual appointment with us to learn more: pelvicpainrehab.com/telehealth/
Hello, I was diagnosed with ic 7 months back...but after cystoscopy and 2 bladder instillations that happened 2months back my symptoms changed I have sharp cutting pain in vagina... sometimes I feel like my inner skin of vagina is sticking and when I lift my leg apart it becomes fine...I cannot sit for more than 20 min..I have bladder pain sensitive to touch.. pain get worse when bladder fills.. please suggest I cannot walk even because of pain..when I bend I feel like there is a string in my clitoris and someone is pulling it..one Dr is saying it's ic another one is saying it's pudendal neuralgia...and I am thinking it's both... please suggest... thank you
Thank you for reaching out. Given your symptoms, we would suggest seeking an evaluation with a pelvic floor physical therapist to help better identify the causes of your pain and create a plan for treatment. Pelvic floor physical therapy can help people with IC and with pudendal neuralgia. You are welcome to make a virtual appointment with us at pelvicpainrehab.com/telehealth/.
Hi My age is 19 year. Over a year I feel left testicle pain,, and I consult a urologist and my all report is negetive,, he give me some pain killer and scrotal support but after 5 day my right testicle have mild pain ,,and sometimes I fell abdomen pain,, this problem I suffered more than one year ,,,I do masterbate very much 2 times a day with pillow by friction ,, and I took long hour for musterbrate ,,,,,,, so please tell me what can I do😭😭😭😭
Thank you for your question. This will be best answered through a virtual session with us. There is no one solution for people with testicular pain and we think it would be best for you to have an individualized approach. You can schedule with us here: pelvicpainrehab.com/telehealth/
Hello I have a question.Can the penis become feeless specially the rich band and the glans at the tip support with ED from compressed pudendal nerve?Plese respond thank you.
Hello, we are not entirely sure what you are asking. If you have specific questions about your state of penile health, we recommend directing them to your urologist for more information.
Mam actually I have suffering with burning penis after micturition there will be no problem with sleeping when i wake up in the morning there will be almost no pain but when i go to bowel movement then my burning micturition increase or when I go to first micturition in the morning my pain starts is this pudendal neuralgia or prostattitis because i went to urologists many times and my culture reports are normal and nothing can they bring out and they kept yelling me using antibiotics pls help me
Thank you for your question and we are sorry to hear what about what you are experiencing. The pudendal nerve can be responsible for pain similar to this but without more information or evaluation, it is hard to say for certain what is causing your specific pain. We recommend you make a digital health appointment with us so we can help you more: pelvicpainrehab.com/telehealth/
Hello. Ty for the video first. Then a very private question, but i would like to ask it anyway: Can the pudendal nerve, or Pudendal Neuralgia cause pain in a man's Penis? Also on one side only (right side)? Sorry and i understand if you like to ignore this question, but if you chose to answer i'd be very thankful.
Hello ! If you are experiencing pain in the pudendal nerve or your genitals, we recommend you been seen by a urologist (to address the pain in the penis) and then a pelvic floor PT (to address the pudendal pain). This dual approach will help make sure your pain is fully addressed and that your pelvic health is being treated. For more info about penile pain, check out of videos on that specific topic!
Can it cause a sort of itchy sensation in the anus, perineum area? It's not like a typical itch, no pain urinating, but just kind of a weird sensation like I want to to reach I side me and kinda scratch around. I'm not joking here either.
@@Tristan-fh5ui Thank you for your question. The pudendal nerve does not go into the legs. It is only responsible for sensation and motor function in the pelvis. Tightness in surrounding areas sometimes results because of clenching the muscles or because of inactivity either because one is fearful of movement or unable to move due to pain.
I have had my right hip replaced and then revised. My right hip is very stiff and I limp a lot. About a month ago I started having urinary urgency and frequency. I also have a lot of pressure in my lower abdomen. I was dx with cystitis. I am not sure, I have true cystitis. I am having a very difficult time coping. Can you help?
Thank you so much for sharing your story with us. Your feelings are so valid. The symptoms you present with sound like a referral to pelvic floor physical therapy would be a great start! Here is a blog that you might find informative: pelvicpainrehab.com/female-pelvic-pain/female-interstitial-cystitis-painful-bl[…]d-news-interstitial-cystitis-is-treatable-a-much-needed-qa/
This was the most informative video I have found. I was initially diagnosed with pirifomis syndrome. The PT was making me worse. Now this makes sense.
That is so kind of you to say! We are so happy to hear it's been helpful!
Great advice, thank you. The mental health aspect mentioned is truly also a big factor.
You are absolutely welcome! Thank you for listening along.
Mine started playing up just after going through a very emotional event. Fascinated to hear you mention this could be a part cause. Thanks.
You are so welcome!
Same for me… I had a nervous breakdown.
@@JuliaLanski Sorry to hear that.
@@HarryFenton6124 Same here ! Mine got improved overall , it took awhile, lots of long deep breathing, stretching and meditation 🙏🏻❤️
@@JuliaLanski We are so sorry to hear that was your experience. How are you doing today?
This is extremely informative, thank you so much.
You are welcome!
Thanks for this video. It is incredibly informative and I will share will one of my new yoga students.
Thank you for sharing!
Thank you for this Informative Video. Fascinating actually. I suffer with an affliction which is affecting my rectum. Bowel / Bladder urgencies and Incontinence. I have an Overactive Bladder (per my Urologist) with some BPH of the prostate. Moreover, I have S1-L5 Spondylolisthesis, Spondylosis of the Lumbar, Thoracic and Cervical Spine. Mild to Moderate stenosis at various sites and Lumbar Dextroscoliosis at 25 degrees stemming from a 1" shorter right leg. I'm a 72 YO, Male. I fractured the Femur in 1966 playing HS Football. The LLD was left unaddressed for decades and after about 20 years late - age 36 - the lower back stiffness and discomfort from bending over (Like Vacuuming) was setting in. The SI joints have been chronically Inflamed. My Neurologist told me that many Back Problems start at the SI Joints as "Ground Zero" for back problems. The issues traverse up the spine all the way to C1 - like me. 48 Years of driving / commuting to & from work /home at least 3 hours (or more with NY Traffic) has taken a Major Toll on my spine (not just my Wallet!). I get Saddle Anesthesia on & off for a few years. Cauda Equina was Ruled OUT. It's a Piriformis issue for sure. My GI NP, just conducted a rectum exam with electrode probs to measure the holding and pushing strength in the rectum. She has recommended Pelvic Floor PT. Would this be a pudendal Neuralgia situation too?
When you say "Pudendal neuralgia is a mechanical condition" it is the most validating thing....as though years of gas lighting falls away. I know this to be true and the few PTs who have helped me with PN treated me for mechanical issues which brought me relief...but I had to travel out of town for this, and in trying other local PTs so many are misinformed and just presume a central nervous system problem and encourage me to load the nerve more or to tighten which causes worsening...even though I respond to local manual therapy (and local medical therapy for my bladder inflammation condition--primary driver caused the PN). I have to work so hard to convince them it is a mechanical condition :( . Your book and videos are such a huge help.
It is a condition that has a lot of information (good and bad) out there! Pudendal neuralgia can be tricky when you don't fully understand the scope of it (as a provider). We are glad that our videos/book has been helpful and validating to you. You can also subscribe to our blog for more evidence based information pelvicpainrehab.com/category/female-pelvic-pain/female-pudendal-neuralgia/
i have PNE from pro cycling since 2005 . I have taken all meds and tryed all exercises and theraphy .
I found the perfect combination of meds which i take every day and live a pain free life.
1. TRILEPTAL 300 MG ( anticonvulsinant)
2. XANAX 0.5 MG ( ansiolitic)
take 300 mg trileptal plus 0.5 mg xanax 7 am. 11 am 3 pm and 7 pm.
lots of water.
very loose underware and pants.
use a palvic floor seat cushion always!
have a happy life.
We are happy to hear your pain is managed and thank you for sharing!
@@PelvicHealth Apart from the meds every morning its important to stetch the pelvic flor and lower back .
it is a very frustrating condition and the best solution is combining these meds with the exercices ...also sometimes its important to take muscle relaxing meds ..the best is called MELOXICAM 15 mg. the anal obturator muscle has to be relaxed , otherwise it will cause pressure on the nerve and a burning sensation.
its also good to use some vaseline to lubricate the anus when going to the bathroom , and use talc in the perineal area and between the legs so the underware wont rub against the skin . this pinching needle feeling in the skin is calked alodimia , and with talc it will calm down .
I am not a fan of the surgery , only 10% of people feel some relief after 2 years , some can even feel worse.
Do not do accupunture .
Do not do electric theraphy.
You matress has to be very soft , not hard or orthopedic , it will hurt more the nerve.
Use very soft and confortable tennis or running shoes..the pudendal nerve has roots that end in the feet and hard shoes are not a good idea.
@@eduardonessim4499 thank you again for your comment! Everyone reacts differently to medication, so it's great to have other share their experiences in case others might benefit to something similar. Additionally we could not agree more with you about stretching your pelvic floor and stretching in general.
Thank you so. Uachtaran for this
Eduardo Nessim remember me, you are lucky your still pain free from the meds.
Thank you for this informative video!
You're welcome!
This video is very useful, thank you. It’s for the first time when I hear about a connection between walking barefoot and pudendal neuropathy. I walked barefoot all my life inside my house and because I mainly work from home that’s actually most of the time. I would find extremely weird to wear shoes inside the house but I’ll try. Would some slippers with thick soft sole do, instead of sport shoes?… so I can take them off easily when I lay down.
It is best to wear an athletic shoes or other footwear with arch support.
@@PelvicHealth thank you for your advice.
Very informative info.. I have
how about tips for pudendal neuralgia nerve decompression surgery recovery, please?
This is a great idea for future discussion. Surgery recovery is a big topic. Recovery will vary, so it's useful to have a physical therapist to guide you through it. It will likely include a gradual return to sitting and activities that aggravated your symptoms. Be patient, because the full recovery can take many months. Check out this video for some more information about the surgery. ruclips.net/video/JrfHKVlpb1A/видео.html
Is it possible to have pudendal neuralgia without having urinary or bowel incontinence symptoms ?
Hi Pooja, yes it is possible to have PN without urinary or bowel involvement. Some people with PN only have altered sensations or nerve pain in the distribution of the nerve. While the nerve innervates part of the urethra and the anal sphincter not everyone has symptoms in these areas, teh symptoms depend on which nerve branches are affected and how involved the pelvic floor muscles are.
Thank you for this video. I gave birth 3 months ago and have had really sharp pain. Everything you said are the exact symptoms I’ve been documenting.
You mentioned avoiding certain exercises or movements. Is this something we need to do indefinitely or will the nerve heal? I can’t imagine living with this pain forever. 😓
Limiting the movements and exercises is meant to reduce stress on the nerve and surrounding tissues to support the healing process. Everyone's process is a little different, but yes, the idea is to be able to gradually incorporate those activities in the future.
@@PelvicHealth thank you so very much for your response. 🤍
Thanks a lot
You're welcome.
Hi, hope you could answer a question: I know this might be silly but is it possible that pelvic tension/pain can shift from one place to another? say from rectal to prostrate, or from urethral to pubic? Not sure if this is weird but this has been occurring for me every few hours.
Hi Aditya, this is not a weird question at all, and symptoms can move between all of the areas you mentioned. The pelvic floor muscles attach at the pubic bone anteriorly and the coccyx posteriorly. In addition the pudendal nerve innervates the majority of the pelvic floor muscles, the genitals, the anus, and part of the urethra and rectum. For these reasons and connections symptoms can occur in any of these locations.
@@PelvicHealth Thank you so much for such a detailed answer.
@@adityaj950 You're welcome!
@@PelvicHealth can a person feel like something is biting in rectum and vagina at sudden in pudendal neuralgia. My mother is suffering from all you mentioned symptoms plus this from more than 8 years after hysterectomy. Please reply, what is this
@@bhartiyaveerangna9412 Hello, without a full examination and talking to her, we cannot advise exactly what it is. We highly recommend she see a pelvic floor PT to evaluate her pelvic health.
This is incredibly useful information. Thank you for sharing! I’m not yet diagnosed with PN but the more I know about it, the more I’m sure that’s what’s happening to my body these last 3 years. I was diagnosed with vulvodynia, had a full vestibulectomy and got even worse. I think that my symptoms fit perfectly with PN but I can’t understand why I get my burning sensation on the vulva to go from a 10 to a 2 as soon as my menstruation starts. That’s what puzzles me… Do you have have idea of why that might happen?
Thank you so much for sharing and great question. It definitely seems like something in relation to a hormonal shift since you notice a change during your menses. We would recommend seeing a doctor to rule out yeast or BV. pH changes once menses starts and yeast infection type symptoms sometimes actually improve during that time. PN wouldn’t typically behave this way. Seeing a sex med specialist would be a good step and if you haven't seen a pelvic floor PT as well that would be beneficial. Hope this was helpful!
I live in the Netherlands. How can I reach you by phone? for explaining my symptoms and advice from you ? please this is urgent
what is the best thing to do for urinary frequency due to pudendal nerve ? exercise ? medication ? any advise ?
thank you for the work
We would advise seeing a pelvic floor PT who can evaluate your pelvic floor and take into consideration your symptoms. Without an evaluation, we could not say what the best thing is to you, as we would need more information.
Hi . Iv had a raw feeling in my vulva which is red too. It’s not a pain as such but feels very raw . Iv tried many lotions and creams but vagisil is the only one that gives my some relief . Please help me . Thank you. X
Thank you for sharing with us and you are not alone. This sounds like a referral to a gynecologist for an evaluation would be a first step. They can rule out any infection that can be occurring. Then seeing a pelvic floor physical therapist may be a next step as well. Also, here is a blog post that goes over different diagnoses that may be involved with the symptoms you are describing.
pelvicpainrehab.com/female-pelvic-pain/vulvodynia-female-pelvic-pain/5458/ten-[…]eed-to-know-about-vulvodynia-vestibulodynia-and-vaginismus/
Hope this is helpful!
@@rstein3131 yes I went to gynaecologist. She said I have lichen planus. Could have it for life. Steroid cream & wash cream . Look it up on utube. You can have it anywhere on your body . Mine is the vulva. I’m nearly 75 years old. Hopefully it goes away 🤞
Had a very difficult childbirth in 1974 and was immediately unable to sit for over a few minutes without burning. After 11 months and extremely painful steroid shots in the region, the docs decided I must had broken my coccyx during the birth and I should have it removed. I had the surgery but nothing changed with the burning. That was in 1974.
Just recently I discovered the term "pudendal neuralgia" and am trying to find a doc who works on this. I've told doctors about this burning when I sit or lie on my back since the birth, and most think I'm a hypochondriac.
I was diagnosed with fibromyalgia in 1993 and just recently diagnosed with small fiber neuropathy. I do not have diabetes, am not obese. ??
Burning pain with sitting or lying on your back can be a symptom of pudendal neuralgia. You are welcome to schedule a digital health appointment with us to discuss your case. The International Pelvic Pain Society website may help you find a doctor who is familiar with this type of pain.
@@PelvicHealth Thank you!
i if you have no problem sitting and the symptoms start only with walking is this considered prudendal pain,
We cannot make a diagnosis without an evaluation. Please check out our blog for more resources + info about Pudendal Neuralgia pelvicpainrehab.com/male-pelvic-pain/male-pudendal-neuralgia/16225/pudendal-neuralgia-resources-updated/
Hi i wanted to ask if having severe pain can also lead to fever and low blood sugar ?also can it effect other nerves in your feet or arms?
Severe pain may cause blood pressure changes which can lead to lightheadedness. If the pain is coming from a peripheral nerve or muscle it should not cause fever and low blood sugar. PN does not typically cause pain in the arms and can be associated with pain in the legs.
With pudendal nerve entrapment, does anyone have flatulence without knowing? Major problem for me.
Thanks for asking! Sometimes this can occur when the pelvic floor muscles aren't functioning as they should. In some cases, the muscles are too restricted that it makes it hard to control gas, or the muscle may be too lax and weak which can allow gas to sneak out. Sometimes this may occur as a direct result of pudendal nerve entrapment when the nerve is unable to send signals like it is used to. In other cases, it is due to purely muscle function which may be a secondary finding. Here are great blog posts about entrapment versus neuralgia which may help to answer your question more:
pelvicpainrehab.com/male-pelvic-pain/male-pudendal-neuralgia/726/how-do-i-know-if-i-have-pudendalneuralgia-or-pudendalnerveentrapment/
pelvicpainrehab.com/male-pelvic-pain/male-pudendal-neuralgia/16132/ig-live-q-a-pudendal-neuralgia-pudendal-nerve-entrapment/
Hi,it’s been 45days i had a Endoscopic disk surgery, Now i am pain free but before my operation and now on while i am sitting motorcycle or riding motorcycle my penis got numbness like pins and needle sensational feeling, why this is happening and what should i do? Hope u will be helpful for me
Hello, We recommend you see a pelvic floor PT to address the pelvic pain you are experiencing. We wouldn't be able to say one way or another what your pain is or where it is coming from (if it's related to the pudendal nerve), without physical evaluating you. We recommend finding a PT to evaluate you and your pain.
I am male and after sitting on a hard chair to do some computer work I noticed a tension in the perineal area. A misdiagnosis of prostatitis first then the dr came to the conclusion I had Pudendal nerve damage. I was put on Gabapentin and codeine. 18 months later and things are just getting slowly worse. I have had no relief whatsoever and these pills are slowly killing my mind. I walked out in front of heavy traffic last week, I didn’t even know where I was going! Ive forgotten how to play the guitar, I can’t ride my bicycle or motorcycle anymore and to travel by car I have to wedge 2 thick wooden blocks underneath my upper thighs to keep my perineum from touching base. Looks like I’ll be living with this. Here in the UK unless you are very wealthy, there is no recourse to any facility or neurological help whatsoever.
You are always welcome to schedule a virtual consult with us if you would like to review your case and see if there is anything we can help with. pelvicpainrehab.com/telehealth/
Hey man. I am suffering with Pudendal Neuralgia too. This is my second time experiencing it. First time was in 2017, it last about 8 months. This time I have been suffering with it since early June, so about 6 months. I am just checking in to see how you are doing? I was put on Lyrica, nerve pain meds the first time and they messed my mind up too. I had to get off them. I hope you are okay my friend. It has been 3 months since you wrote this comment, how are things now? I am holding onto hope that I beat this the first time around so I can do it again.
@@ryanrichards4901 how did you beat it first time?
@@KJ-pu8dw Hi, the first time I didn't do anything in particular really I just waited it out. It started to improve after 8 months and slowly got better. I just tried to manage it daily by not sitting down for too long. I also stopped having sex completely.
Unfortunately this time around I am still suffering with it. I am 9 months into this time with no end in sight. It is a lot worse this than the first time.
I have recently started taking Endep so hopefully that works.
Julie Sarton at Sarton Physical therapy, Read Alan Gorden's The Way Out, Dr. Hibner in Arizona can help. Praying for u
How can we lengthen the obturator inturnus I had bike accident. And get pain in testis when I move my left leg towards my chest
There are various ways to lengthen the obturator internus. One can do this with a self stretch or a physical therapist can lengthen the muscle manually within the pelvic floor which they would access via the anus for a male. The pain in the testes should be fully evaluated by a urologist to rule out any testicular pathology. Pain in the testes could also be coming from the spermatic cord which could be irritated. Bringing the knee to your chest would compress the spermatic cord, therefore, if it is already irritated, bringing the leg towards your chest could further irritate it.
@@PelvicHealth I had a bike accident broke got Crack in ishial spine on right and sit bone of left and it hurts left testis to pull left leg towards chest , it hurts burning like throughout the day , comes for seconds even if I don't pull leg to that angel . What to do . Plz help I am afraid . And also got bladder injury . Will I be able to sit pain free . I am on complete bed rest since 2 months. Plz plz help me . And I didn't understand how I can self stretch or how phisiotherapist would do via anus plz plz reply and help. Left testis left side part hurts . I am on catheter got negative infection test also not able to urinate without catheter plz plz plz plz help help help I can't see my parent in pain . Plz give knowledge and solution
@@adityastyles259 I'm sorry you're in so much pain. It is virtually impossible for me to hypothesize what is causing your pain with this information. If you have a pelvic fracture, which is sounds like you do, I think you have to allow that to heal first before pursuing any sort of pelvic physical therapy. Hopefully allowing these injuries to heal with time will reduce your pain.
@@PelvicHealth I got scrotum ultrasound he said testis displacement
I had an anal fissure which became chronic but finally healed after 6 months. The fissure is fully healed, as per my colorectal doc. But new pain cropped up, hip & back, deep rectal tightness, inhibited urination and on and off constipation… my CRS diagnosed pelvic floor dysfunction, and thankfully referred me to a pelvic floor PT. PFPT told me a lot of my symptoms are coming from pudendal neuralgia, tight pelvic floor and tight QL, overactive sympathetic nervous system and tight obturator. PFPT is helping but I’ve noticed it’s way worse lately because I’ve had tremendous life stress hitting me all at once. Is this all connected?
That is good news to hear that the PFPT is helping. Stress can absolutely be connected and make some of your pain worse. Do you have ways to manage your stress? Or have you tried any mindful techniques to help work with the pain causes by your stress?
I have trigger points in my muscles and a nervous system dysfunction every once in a while. PN started as a result of long and horrible fights with my SO. Now I am absolutely terrified that this might last long. Does it ever go away?
Thank you for reaching out. The key to treating PN is to make sure you are addressing all musculoskeletal and neuromuscular impairments. Pelvic physical therapy is an important part of this, so we would recommend getting an evaluation by a pelvic physical therapist. We offer virtual appointments here: pelvicpainrehab.com/telehealth/
Hi I fell on the floor 2 years ago on a setting position and after 3 weeks of this accident I developed pain during urination and around vulva it's like burning sensation. only one week ago I discovered that I have pelvic floor prolapse i have a desending pernium and rectocele.can this be the cause of my pudendal neuralgia and why it flare up only when I fell ???thank you 😊 for helping us with alot of helpful information 💁♀️ 😊
Typically pelvic organ prolapse does not cause pain. This includes a rectocele. Pelvic organ prolapse should not compromise your pudendal nerve. Your pain is more likely coming from the pelvic floor muscles and/or the pudendal nerve becoming irritated from the fall onto your buttocks. A fall on one's buttocks is a fairly common mechanism of injury to the pudendal nerve.
@@PelvicHealth Thank you so much for answering so quickly. I am actually from Egypt and the knowledge here about pudendal neuralgia and pudendal nerve entrapment is very limited. I have started physical therapy because my doctor told me that the grade 2 rectocele and grade 2 descending perineal syndrome might have caused the pne because it streched the nerve but the trigger point that caused my symptoms is the fall, is this true? If the pain developed from the muscles like you said do stretching and strengthening exercises help or how should I deal with it. Is the irritation the same as entrapment and if I have irritation what can I do to help cure my symptoms? Finally, what do you think about pudendal nerve decompression surgery? Do you think it can releive my symptoms and cure me? Once again I'm really happy for your help and would like to know any extra information as the information here is very limited
@@alshimaaeleffish3205 I think it is doubtful that the pelvic organ prolapse caused the pudendal neuralgia. I think it is much more likely that the fall caused the pain. The fall may have caused some inflammation around the nerve and/or around the sacrospinous and sacrotuberous ligaments, which the PN runs in between, which could have led to the neuralgia. The muscles surrounding the nerve may have responded to the pain by tightening. Obviously I can't be sure without evaluating you myself. An irritation is not the same as entrapment. I think it is very doubtful that you have entrapment. I would not pursue a nerve decompression surgery before exhausting conservative therapy (physiotherapy) first. A decompression surgery is for pudendal nerve entrapment. A combination of pelvic floor physiotherapy and pharmacotherapy (medications) would likely resolve your pain over a series of months.
@@PelvicHealth thank you so much for replying. It's really hard to find any information here in my country which made me extremely depressed thank you for your help, I will always remember your tremendous helping. I am currently seeing a physiotherapist but she is new to the field and she hadn't really had anyone that has my condition. She started by giving me some strching exercises. Can you help me by telling me about any videos that you recommend especially for the inflammation and what medications I can take for the inflammation. My physiotherapist also wanted to strengthen my muscles because of my rectocele. Can this irritatate the nerve more? Finally some of the exercises she gave me included squats, is this bad for the inflammation. The pain in my vulva comes and goes by itself (without any medication) but pain during urination is constant. When I took antidepressants (SSRI) for 9 months the pain in my vulva went away but the pain in urination stayed and wasn't releived by the SSRI or gabtenin what is this related to and what is the cause of it. Is it the tight muscles around the urethra? My symptoms also become worst before my period but during my period there is no pain except when urinating. Should I do a cystoscopy to look for any cysts? We did an ultrasound but only found tiny nabothian cysts. Finally is endometriosis found on ultrasound or are there any other ways to diagnose it? Because some of her symptoms relate to endometriosis. Can any other cysts cause this kind of pain? Because I sometimes doubt entrapment or normal inflammation because I don't have any rectal symptoms.
@@alshimaaeleffish3205 Since you have multiple questions that really require a little more information for me to answer them comprehensively, I would suggest that you schedule a telehealth appointment with me so we can discuss your questions and I can try to give you as much helpful information as possible. You can schedule a telehealth appointment with me via this link. On that page, click on the icon for the "East Coast" and you can schedule an appointment with "Liz" via that link. pelvicpainrehab.com/telehealth/
Does walking trigger this nerve?
Many people are able to walk without issue. But sometimes taking larger steps or walking up hill can be provocative for some. It is always best to work with your pelvic floor PT who can help you come up with strategies!
I’ve been bedridden for about a year and this is one the pudendal neuralgia started. I never hear about being in a lying down position, causing this a pain. The pain is severe whether I stand, sit or lie down. The doctor said that because I will probably be bedridden for another year or more and there is no way I can help my condition.:(
Thank you for sharing your story and we are so sorry to hear what you are going through. Staying in bed is often times not a good solution. Without knowing the details of your case, it is challenging to give you specific advice. We do offer virtual consultation and would be happy to help you formulate a plan. pelvicpainrehab.com/telehealth/
I developed this after having a laparoscopy. It literally feels like someone set my entire pelvis on fire. I’m on gabapentin and going to PT. Scared this is going to last forever.
I'm sorry to hear that you're experiencing symptoms of pudendal neuralgia. I'm glad that you are taking medication and seeing a PT who can help. PN pain does not always last forever! Here is one of our success stories of a patient with PN who recovered under our care.
pelvicpainrehab.com/male-pelvic-pain/male-pudendal-neuralgia/6508/recovered-from-pudendal-neuralgia-sheyoumes-success-story/
pelvicpainrehab.com/pudendal-neuralgia-causes-symptoms-treatment/
If your symptoms aren't progressing, it may be worth a telehealth appointment with one of our PTs who specialize in PN. You can book a telehealth appointment here: pelvicpainrehab.com/telehealth/
Good luck with your treatment!
@@PelvicHealth thank you!!
Sympathetic sensory and motor fibres? What does that mean exactly. I have a feeling my neuralgia is only from emotional stress.
"Sympathetic sensory and motor fibres" mean the nerves that carry messages to and from the brain, respectively. The brain collects information from the whole body and decides what kind of sensation to produce, such as pressure, itch, or pain. Emotional stress of any kind will add into the brain's calculation. You are likely right. Even when neuralgia was triggered by an initial injury that has healed, emotional stress can be the main driver. There are psychologists who specialize in pain to help people in this situation. These books may also help.
www.amazon.com/Explain-David-Butler-Lorimer-Moseley/dp/0987342665
www.painpsychologycenter.com/the-way-out/
How can I differentiate that my pain in the pelvic is because of Pudenal neuralgia or CPPS
It can be very hard to determine and you need to work with a skilled team to rule in and out all possible sources of pain. There can be a lot of overlap between the 2 diagnoses. We recommend a virtual consult with us so that we may better help you. pelvicpainrehab.com/telehealth/
Can I do lunges , split squat , bridge , and core excercise like dead bug leg raise and Russia twist?
Hello! Without seeing you, we cannot advise certain exercises. We recommend checking in with your pelvic floor PT to assess what exercises are most appropriate for you and the state of your pelvic floor.
@@PelvicHealth hello, Yes that would be great but the country I'm in doesn't really have pelvic specialist, So if you really tell me how can I check my pelvic floor as I'm an athlete and I can't stop my workout and other training. Thank you
@@zubairrahman3679 Unfortunately there is not a decent way to explain to someone how to “check” their PFM on their own without some hands on guidance from a clinician. One way, although not a very good way, would be to insert one finger vaginally or rectally, squeeze the PFM/do a Kegel, then observe what happens. Do you feel a good squeeze? If so, does it fully release after you relax the contraction or does it stay contracted for a few seconds after you’ve let go. If this is the case it *could be an indicator that your PFM are too tight. If that’s the case they could use a to try pelviwand to stretch the PFM and/or PF drops and diaphragmatic breathing.
Hello , i have PNE from cycling in the perineum area , can u help me with some exercices , streches , anything pls ? tyty
Hi! While we do not have specific stretches from cycling, we do have a few informative blogs about pain from cycling that you might find beneficial! pelvicpainrehab.com/pelvic-pain/6787/as-the-bicycle-turns-cycling-and-the-pelvic-floor/
pelvicpainrehab.com/pelvic-pain/7858/have-a-pain-in-the-a-while-sitting-on-your-bike-saddle-optimize-your-saddle-using-pressure-mapping/
Additionally, we have some yoga (stretching) for PN on our Instagram page, that you should find useful instagram.com/tv/CPn91_MJRra/?
Use special cushions also described in a video of this channel ruclips.net/video/sStY4NbHwP4/видео.html and ruclips.net/video/y24j0nXZ9V0/видео.html and see online for donut or round cushions . And for sleep buy air bed or lie on left side and take alpha lipoic acid (ala) specially and other supplements check on you tube this will help heal
Can it cause burning pain only at 3 points on vulva right side
Yes, the pudendal nerve can cause specific burning on one side of the vulva if a specific branch of the pudendal nerve is irritated, likely the perineal branch.
Hello! any feedback would be appreciated - I have dull rectum , perineum, and base of penis pain that fluctuates and is mostly noticeable when having sex and ejaculation seems to make it flare up afterward. I have seen 3 urologists and now doing PF physical therapy but the therapists doesn’t seeemed to be focusing on pudendel neauralgia which my best guess is this is what it is , the sexual dysfunction and pain is very hard to deal with, any further advice
Hello! Without seeing you to consult more about your case, we cannot advise more. If you would like to see us virtually for a consult, we would be happy to help! pelvicpainrehab.com/telehealth/
Can PN cause pain, some numbness and also slight arousal in the clitoris?
Yes. The dorsal branch of the pudendal nerve innervates the clitoris and can cause all these sensations. See a pelvic PT to get treatment.
Excuse me, this problem can also affect erections? Because I feel them weaker
Hello! Yes absolutely Pudenda Neuralgia can affect erections. If you have PN and need treatment, we recommend seeing a urologist and then possibly incorporating a pelvic floor PT into your care team to address your symptoms.
Can endometriosis cause puedendal nueralgia
Yes. Changes in tissues and structures around the pudendal nerve can lead to nerve irritation and pain. A pelvic PT and a good pelvic pain doctor would be helpful in this situation.
I have been dealing with increased sensitivity in the glans of the penis. It looks a bit discolored and it feels scratchy when I’m wearing pants. I’ve been to the doctor and urologist and they say there is nothing wrong with me. Is this a nerve issue or symptoms of nerve issue.
Just lately for me things are getting worse. I now cannot lift my left leg towards me in a standing position ie to put on a shoe or sock? The pain in the adductor longus area is preventing me from doing this movement. I have lift my own leg and hold it now to put footwear on. My right leg is still strong and has full range movement. Would this symptom help in identifying the area of pudendal entrapment for me? Many thanks to you for any reply.
Also forgot to mention, it could be the top of sartorius I’m thinking? Also my gait is very affected lately and some days my feet are excruciatingly painful. I’m not enjoying it at all I tell you!
Sorry to hear that your symptoms are getting worse. It definitely sounds like a myofascial issue and/or pelvic girdle dysfunction. If you have not seen a physical therapist, I highly recommend doing so. They can assess your gait, posture, and pelvis and help identify the cause along with recommending specific stretches or exercises that will help. If there is anything concerning, they will also be able to recommend providers in your area that may be able to provide medical management or further testing if necessary. Often times when joints aren’t moving properly or there are changes in the muscle tension relationships, these types of symptoms occur.
You’re very kind to reply to me, I really appreciate it. Things in the uk have gone from bad to worse lately with regards to even getting a local GP to consult with. Seems they’re just throwing meds at us. Anyway, I will keep trying my luck at getting a response and even maybe a diagnosis. But my sincerest thanks to you again.
A year on and I have just got progressively worse. Both of my greater trochanter muscles are so tender, pushing them in is like an electric shock. It seems there lies the pudendal nerve irritation?
I saw a chiropractor/physiotherapist who literally made things even worse. Since he treated (ruined) me, I can’t move my neck from side to side, I have 2 frozen shoulders, also my sacroiliac is so tense and painful. I also now have neuropathy in both feet, I either can’t feel them or they burn like crazy. Could be sciatica I suppose?
The drugs I take are basically keeping me numb so I don’t dwell on things any more. Ah well, it could always be worse. I’m still walking and doing some light weights on a bench which helps keep me insane lol 😊
Hey question, So my Pudendal nerve irritation happened 3 months ago due to a horribl session of edging, I abstinated from sex and masturbation for a month and i have immense burning inside my rectum area. I also had masturbated for 3-5x a day. I'm seeing a PT right now, this is my 4th session of internal work where shes pressing on my trigger point for 30 secs and then massaging the muscle around. However I do feel burning intensely, shes saying my Pudendal nerve is irritated, do you know how long it takes for nerves to heal from excessive masturbation or edging? How do i go on about this?
Thank you for your question and so glad to hear you found a pelvic floor physical therapist! A few things to think about would be 1. Does the pain change at all during the session and/or are you getting relief despite having the pain during the treatment? Nerves can be slow to heal, and everyone is slightly different. We have noticed with many male patients it has been helpful to use a bit of “Anecream” (lidocaine cream) as the anal tissue is irritated and this allows for more tolerance to PT when addressing the muscle aspect. Its worth asking! Additionally, it may be worth discussing with your team of providers if a PN block may be helpful in order to better tolerate addressing the muscular portion if that is inhibiting progress.
Is there any way to cure pudendal neuralgia?
There absolutely is but it is dependent on the root cause! Often times, people need to work with a multidisciplinary team to address all aspects of their symptoms. You can schedule a virtual appointment with us to learn more: pelvicpainrehab.com/telehealth/
Hello, I was diagnosed with ic 7 months back...but after cystoscopy and 2 bladder instillations that happened 2months back my symptoms changed I have sharp cutting pain in vagina... sometimes I feel like my inner skin of vagina is sticking and when I lift my leg apart it becomes fine...I cannot sit for more than 20 min..I have bladder pain sensitive to touch.. pain get worse when bladder fills.. please suggest I cannot walk even because of pain..when I bend I feel like there is a string in my clitoris and someone is pulling it..one Dr is saying it's ic another one is saying it's pudendal neuralgia...and I am thinking it's both... please suggest... thank you
Thank you for reaching out. Given your symptoms, we would suggest seeking an evaluation with a pelvic floor physical therapist to help better identify the causes of your pain and create a plan for treatment. Pelvic floor physical therapy can help people with IC and with pudendal neuralgia. You are welcome to make a virtual appointment with us at pelvicpainrehab.com/telehealth/.
@@PelvicHealth thank you so much
Hi My age is 19 year. Over a year I feel left testicle pain,, and I consult a urologist and my all report is negetive,, he give me some pain killer and scrotal support but after 5 day my right testicle have mild pain ,,and sometimes I fell abdomen pain,, this problem I suffered more than one year
,,,I do masterbate very much 2 times a day with pillow by friction ,, and I took long hour for musterbrate ,,,,,,, so please tell me what can I do😭😭😭😭
Thank you for your question. This will be best answered through a virtual session with us. There is no one solution for people with testicular pain and we think it would be best for you to have an individualized approach. You can schedule with us here: pelvicpainrehab.com/telehealth/
Hello I have a question.Can the penis become feeless specially the rich band and the glans at the tip support with ED from compressed pudendal nerve?Plese respond thank you.
Hello, we are not entirely sure what you are asking. If you have specific questions about your state of penile health, we recommend directing them to your urologist for more information.
Can this cause urgency?
Yes it can.
Can this problem cause numbness from the belly button down towards the pelvis?
Hi Moxie, the pudendal nerve does not supply sensation to the lower abdomen, if the pain is in this region it may not be pudendal neuralgia.
@@PelvicHealth I figured out what it was. Thank you for your reply.
What was it?
@@ansammohammed3630 radiculapathy
Mam actually I have suffering with burning penis after micturition there will be no problem with sleeping when i wake up in the morning there will be almost no pain but when i go to bowel movement then my burning micturition increase or when I go to first micturition in the morning my pain starts is this pudendal neuralgia or prostattitis because i went to urologists many times and my culture reports are normal and nothing can they bring out and they kept yelling me using antibiotics pls help me
Thank you for your question and we are sorry to hear what about what you are experiencing. The pudendal nerve can be responsible for pain similar to this but without more information or evaluation, it is hard to say for certain what is causing your specific pain. We recommend you make a digital health appointment with us so we can help you more: pelvicpainrehab.com/telehealth/
Hello. Ty for the video first.
Then a very private question, but i would like to ask it anyway: Can the pudendal nerve, or Pudendal Neuralgia cause pain in a man's Penis? Also on one side only (right side)? Sorry and i understand if you like to ignore this question, but if you chose to answer i'd be very thankful.
Hello ! If you are experiencing pain in the pudendal nerve or your genitals, we recommend you been seen by a urologist (to address the pain in the penis) and then a pelvic floor PT (to address the pudendal pain). This dual approach will help make sure your pain is fully addressed and that your pelvic health is being treated. For more info about penile pain, check out of videos on that specific topic!
Can it cause a sort of itchy sensation in the anus, perineum area? It's not like a typical itch, no pain urinating, but just kind of a weird sensation like I want to to reach I side me and kinda scratch around. I'm not joking here either.
Itching can be a symptom of neuralgia.
@@PelvicHealth if this nerve is pinched. can it cause your muscles in both legs to be tight? maybe because of the pain?
@@Tristan-fh5ui Thank you for your question. The pudendal nerve does not go into the legs. It is only responsible for sensation and motor function in the pelvis. Tightness in surrounding areas sometimes results because of clenching the muscles or because of inactivity either because one is fearful of movement or unable to move due to pain.
@@PelvicHealth but the sciatic nerve will jack up your leg right?
Squaty poty?
Hello, please refer to this link www.squattypotty.com/
If you smoke then stop. Nicotine made the pain much worse.
Thank you for your input!
I have had my right hip replaced and then revised. My right hip is very stiff and I limp a lot. About a month ago I started having urinary urgency and frequency. I also have a lot of pressure in my lower abdomen. I was dx with cystitis. I am not sure, I have true cystitis. I am having a very difficult time coping. Can you help?
Thank you so much for sharing your story with us. Your feelings are so valid. The symptoms you present with sound like a referral to pelvic floor physical therapy would be a great start! Here is a blog that you might find informative: pelvicpainrehab.com/female-pelvic-pain/female-interstitial-cystitis-painful-bl[…]d-news-interstitial-cystitis-is-treatable-a-much-needed-qa/