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What may be worse than experiencing a painful condition and feeling ashamed to discuss the problem because of its intimate nature? Such is the situation for a lot of struggling with pudendal neuralgia, a little known ailment that affects one of the most sensitive areas of the body. This area is innervated by the pudendal nerve, named following the Latin word for shame. Due to the location from the discomfort coupled with inadequate knowledge, some physicians reference the pain as psychological. But nothing might be more wrong. Unfortunately, discussing the condition with gynecologists, urologists and neurologists often proves fruitless because most know nothing about the condition and for that reason cannot diagnose it.

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Pudendal neuralgia is really a chronic or painful condition that occurs in both women and men, although studies reveal that about two-thirds of these with the disease are women. The main symptom is pain within the genitals or even the anal-rectal area and also the immense discomfort is usually worse when sitting. The pain tends to move around in the pelvic area and may occur on a single or both sides of the body. Sufferers describe the pain sensation as burning, knife-like or aching, stabbing, pinching, twisting and even numbness. These symptoms are often combined with urinary problems, bowel irregularity and sexual dysfunction. Because the pudendal nerve is responsible for sexual pleasure and it is one of the primary nerves related to orgasm, sexual activity is incredibly painful, otherwise impossible for many pudendalites. If this nerve becomes damaged, irritated, or entrapped, and pudendal neuralgia takes hold, life loses the majority of its pleasure.

So, where exactly is the pudendal nerve? It lies deep in the pelvis and follows a path which comes in the sacral area and later separates into three branches, one going to the anal-rectal area, someone to the perineum, and one towards the penis or clitoris. Because there are slight anatomic variations with each person, a patient�s symptoms can depend which of the branches may take a hit, although often all three branches are participating. The fact that the pudendal nerve carries sensory, motor, and autonomic signals increases the number of symptoms that may be exhibited.

Because pudendal neuralgia is unusual and could be much like other diseases, it is often misdiagnosed, leading some to possess inappropriate and unnecessary surgery. At the start of diagnosing process, it is crucially vital that you undergo an MRI of the lumbar-sacral and pelvic regions to determine that no tumors or cysts are pressing on the nerve. Additionally, the individual ought to be screened for possible infections or immune diseases, as well as having an assessment with a pelvic floor physiotherapist to determine the health of the pelvic floor muscles and to uncover whether skeletal alignment abnormalities exist. An accurate patient history is required to assess whether there has been a trauma or an problems for the nerve from surgery, childbirth, or exercise. Tests that offer additional diagnostic clues include sensory testing, the pudendal nerve motor latency test, and electromyography. A nerve block that gives hrs of relief is yet another tool that helps to find out when the pudendal nerve may be the supply of pain.

One of the most common symptoms that accompanies pudendal neuralgia is severe depression. Some people with the disease have committed suicide because of the intractable pain. Because of this, you should consider antidepressants, as they can help decrease the hypersensitivity of the genital area in addition to relieving bladder problems. Certain anti-seizure drugs reportedly help to alleviate neuropathic pain while anti-anxiety drugs provide substantial relief of fits and assist with sleeping. Uninformed physicians are reluctant to prescribe opiates to have an illness that shows no visible abnormality, the desperate nature of genital nerve pain mandates that opiates be advised for these patients. While medications are not always satisfactory, they are doing help go ahead and take edge from the pain for many people. Until the correct treatment methods are determined, it's imperative that patients with pudendal neuralgia receive adequate pain management because the pain related to this illness could be intense.

Treatment depends on the cause of distress to the nerve. Once the cause is not obvious patients are advised to try the least invasive and least risky therapies initially.

    Physical therapy that includes myofascial release and trigger point therapy internally through the vagina or rectum assists with relaxing from the pelvic floor, particularly if pelvic floor dysfunction is the cause of nerve irritation. If no improvement is found red carpet to twelve sessions, nerve damage or nerve entrapment are.


    Botox has become used in medical settings to unwind muscles and shows promise when injected into pelvic floor muscles; though getting a physician adept at this treatment is difficult.


    Pudendal nerve blocks using a long-acting analgesic and a steroid can reduce the nerve inflammation and therefore are usually succumbed a number of three injections four to six weeks apart. 


    If physical therapy, Botox, and nerve injections neglect to provide adequate relief, some patients go for pudendal nerve decompression surgery. 

There are three published methods to pudendal nerve decompression surgery but there is debate among members of the pudendal nerve entrapment community as to which approach is the greatest. Because there are advantages and disadvantages to each approach, patients face considerable confusion when deciding which kind of surgery to select. Since there are merely a number of surgeons on the planet who perform these surgeries, most patients have to travel long distances for help. Moreover, the recovery period is usually painful and takes anywhere from 6 months to several years since nerves heal very slowly. Unfortunately, early statistics indicate that just 60 to 80 percent of surgeries are successful in offering at least a 50 % improvement. Patients whose surgeries aren't successful or who don't desire to pursue surgery have the option of attempting an intrathecal pain pump which delivers pain medication locally helping to avoid a few of the side effects of oral medications. Others pursue a choice of a neurostimulator either to the sacral area or directly to the pudendal nerves. They are relatively recent therapies for pudendal neuralgia so it is difficult to predict success rates. Some pudendalites have devised ingenious contraptions to decrease your pain which range from u-shaped cushions cut from garden pads up to balloons full of water, frozen, and inserted in to the vagina. They have a popular cushion for sitting and many have special computer set-ups for home and office use within to avoid sitting. Generally speaking, jeans really are a no-no, so patients revise their wardrobes to incorporate baggy pants and baggy underwear - if they are in a position to tolerate wearing underwear.

Clearly more research is required to find effective methods to better manage the pain and debilitation of pudendal neuralgia. On the other hand, friends and family near to anyone who has this devastating illness play a crucial role in assisting patients cope, thereby maintaining the highest quality of life possible. Support, love and understanding have primary importance for those struggling with this affliction.