Health Organization for Pudendal Education

Many people have reported flare of symptoms when the area where pudendal nerve runs was pressed.

I was recalling my earlier PT sessions and DRE tests performed by a doctor. I have never had any immediate jolt of pain or experienced any delayed flare while I've had these tests or manipulated internally by PT. Just wondering how common this is and can I make any assumptions whether or not I have a PN?

You could try a PN block and if your pain goes away for a few hours, you can reasonably say the pain is coming from the PN. Of course this will not tell you why you have pain from the PN or necessarily give you treatment options, but it is a piece of information. If you have not had a pelvic MRI, you might consider that to rule out any obvious causes of your pain. If your pain is improving, even very slowly, you also could give it more time and consider these other options later.

Stephanies

theman77 wrote:
I was recalling my earlier PT sessions and DRE tests performed by a doctor. I have never had any immediate jolt of pain or experienced any delayed flare while I've had these tests or manipulated internally by PT. Just wondering how common this is and can I make any assumptions whether or not I have a PN?

The Nantes criteria http://www.pudendalhope.info/sites/defa ... iteria.pdf suggests that when the nerve is pressed on at the ischial spine, that is one of the possible indications of pudendal nerve entrapment, especially if the pain is mostly on one side. But that doesn't necessarily mean that everyone with pudendal neuralgia has this response. The main branch of the nerve runs next to the ischial spine but the nerve branches off after that and you could have irritation at more distal branches. You can have neuralgia without having a nerve entrapment.

Violet

stephanies wrote:You could try a PN block and if your pain goes away for a few hours, you can reasonably say the pain is coming from the PN. Of course this will not tell you why you have pain from the PN or necessarily give you treatment options, but it is a piece of information. If you have not had a pelvic MRI, you might consider that to rule out any obvious causes of your pain. If your pain is improving, even very slowly, you also could give it more time and consider these other options later.

Stephanies

Hi Steph. Thank you for your response and guidance. I'm thinking about trying the PN block, but to be honest I'm not too keen about it. I've heard some individuals become worse after injection. Realistically , whole idea of poking needle anywhere near that nerve scares the shit out of me. Even if the PN block would be successful suggesting a surgery, I don't think there's surgeons here in Finland wIth competence to do anything about it. Traveling to other country to have a surgery is something that I'm not ready to consider...yet.

But how long it is safe to wait for spontaneous recovery until time window closes for surgical intervention? My pain management doctor told me that nerves do not regenerate after 2 years.

theman77 wrote:
But how long it is safe to wait for spontaneous recovery until time window closes for surgical intervention? My pain management doctor told me that nerves do not regenerate after 2 years.

It might depend on the extent and type of nerve damage. Some people have mild pudendal neuralgia for many years without it getting worse as long as they avoid the activities that flare it up.

Violet

Hello,

Sorry to hear about your painful any trying experiences. Hope you are feeling better!

Just wanted to know how you are doing now? Had a bad experience with a prostate massager too.

Thanks in advance.

Reopening this thread - I suffered from a similar injury and am wondering if you've recovered? What worked, what didn't?