Pudendal neuralgia affects the nerve that runs from your lower back, along your pelvic floor muscles, out to your perineum (or the skin between your pubic bone and your tailbone).
According to the Health Organization for Pudendal Neuralgia, common symptoms can range from burning, numbness to feeling of a lump or foreign body in the vagina or rectum.
To better understand the pelvic disorder, I talked to Dr. Allyson Shrikhande, who is a physical medicine and rehabilitation physician based in New York City.
“You can have pain with bowel movements,” she explains. “You can have pain with intercourse. The big one [side effect] is sitting.”
Similarly to endometriosis and the like, the causes of pudendal neuralgia are up in the air. The Women’s Health & Research Institute of Australia says the chronic pain disorder could be related to a combination of issues including childbirth trauma, cycling, gynaecological or colo-rectal surgery, injury, straining, past pelvic or perineal trauma, excessive physical exercise, musculoskeletal issues, posture, and even stress.
Unlike endometriosis and disorders that deeply affect the uterus, men can also experience pudendal neuralgia. Nonetheless, the disorder does affect women in larger numbers.
“[Pudendal neuralgia] can affect the pudendal nerves during vaginal delivery and pregnancy,” she explains. “Gynecological issues, such as endometriosis or fibroids, can irritate the pudendal nerve as well.”
On average, it takes about six months to diagnose a patient with pudendal neuralgia, Dr. Shrikhande says. Luckily, the disorder can be treated using a variety of different methods.
Physical therapy is a significant one, which many physicians will first direct patients to. For instance, as a physical therapist, she helps patients sit on different kinds of cushions to help train them to sit without sitting directly on their pudendal nerves.
If physical therapy isn’t effective, medication is the second option patients can pursue. Muscle relaxers and nerve pain medications can help alleviate symptoms, but they can’t heal and cure the symptoms on their own.
So can pudendal neuralgia be cured completely? Dr. Shrikhande says it all depends on the cause. However, there is a strong chance a cure could be far-fetched, or at least take years to work towards. In any case, chronic pain management is an important factor in patients everyday lives. In addition to physical therapy, patients may have to make lifestyle and work adjustments to accommodate their own needs, such as dietary shifts and finding unique ways to sit.