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Pudendal neuralgia occurs when the pudendal nerve is injured, irritated, or compressed. Symptoms include burning pain (often unilateral), tingling, or numbness in any of the following areas: buttocks, genitals, or perineum (area between the buttocks and genitals). Symptoms are typically present when a person is sitting but often go away when the person is standing or lying down. The pain tends to increase as the day progresses. Additional symptoms include pain during sex and needing to urinate frequently and/or urgently. Damage to the pudendal nerve can result from surgical procedures, childbirth, trauma, spasms of the pelvic floor muscles, or tumors. Pudendal neuralgia may also result from certain infections (such as herpes simplex infections) or certain activities (such as cycling and squatting exercises). There are no imaging studies that diagnose pudendal neuralgia; however, MRI and CT may help to exclude other causes of the pain. Physical therapy is often the first line of treatment.
Source: GARD Last updated on 05-01-20
Many physicians suggest using a step-ladder approach to therapy for individuals with pudendal neuralgia. Physical therapy with professionals who specialize in pelvic floor therapy is often the first line of treatment. Electrical stimulation and biofeedback have been used to assist therapists with treatment. Patients are also given exercises and lifestyle modifications to use at home. For muscle spasms that are not responsive to physical therapy, botulinum toxin has been used in some cases. Medications such as gabapentin, pregabalin, cyclobenzaprine, and tricyclic antidepressants have also been used in the treatment of patients with PN. In some cases, treatment may include nerve blocks, electrical stimulation of the lower end of the spinal cord, or surgery to remove tissues that might be pressing on the pudendal nerve.
Last updated on 05-01-20
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