MessickNowicki352
De BISAWiki
What could possibly be worse than experiencing an unpleasant condition and feeling embarrassed to discuss the issue because of its intimate nature? Such is the case for many suffering with pudendal neuralgia, just a little known disease that affects probably the most sensitive areas of the body. This area is innervated through the pudendal nerve, named following the Latin word for shame. Because of the location of the discomfort combined with inadequate knowledge, some physicians reference the pain as psychological. But nothing could be more wrong. Unfortunately, discussing the problem with gynecologists, urologists and neurologists often proves fruitless since most have no knowledge about the condition and therefore cannot diagnose it.
pudendal neuralgia and heavy lifting
Pudendal neuralgia is a chronic or painful condition occurring in both men and women, although research shows that about two-thirds of these with the disease are women. The primary symptom is pain in the genitals or the anal-rectal area and also the immense discomfort is usually worse when sitting. The pain sensation has a tendency to move around within 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 usually accompanied by urinary problems, bowel problems and erectile dysfunction. Since the pudendal nerve is responsible for sexual satisfaction and it is one of the greatest nerves associated with orgasm, intercourse is incredibly painful, if not impossible for a lot of pudendalites. When this nerve becomes damaged, irritated, or entrapped, and pudendal neuralgia takes hold, life loses the majority of its pleasure.
So, where exactly may be the pudendal nerve? It lies deep within the pelvis and follows a path that comes from the sacral area and then separates into three branches, one going to the anal-rectal area, someone to the perineum, and one to the penis or clitoris. Since there are slight anatomic variations with each person, a patient�s symptoms depends on which of the branches may take a hit, although often the 3 branches are participating. The fact that the pudendal nerve carries sensory, motor, and autonomic signals adds to the number of symptoms that may be exhibited.
Because pudendal neuralgia is uncommon and could be much like other diseases, it is often misdiagnosed, leading some to possess inappropriate and unnecessary surgery. Early in diagnosing process, it's crucially vital that you undergo an MRI of the lumbar-sacral and pelvic regions to find out that no tumors or cysts are pressing around the nerve. Additionally, the patient should be screened for possible infections or immune diseases, as well as having an assessment by a pelvic floor physiotherapist to look for the health from the pelvic floor muscles and to uncover whether skeletal alignment abnormalities exist. An accurate patient history is needed to assess whether there has been a trauma or an injury to 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 provides hrs of relief is yet another tool that can help to find out if the pudendal nerve may be the source of pain.
Probably the most common symptoms that accompanies pudendal neuralgia is severe depression. Many people with the disease have committed suicide due to the intractable pain. For that reason, it is important to consider antidepressants, as they can help lessen the hypersensitivity from the sex organs along with relieving bladder problems. Certain anti-seizure drugs reportedly help to alleviate neuropathic pain while anti-anxiety drugs provide substantial relief of muscle spasms and assist with sleeping. Uninformed physicians are unwilling to prescribe opiates for an illness that shows no visible abnormality, yet the desperate nature of genital nerve pain requires that opiates be advised of these patients. While medications aren't always satisfactory, they do help take the edge off of the pain for many people. Until the correct treatment methods are determined, it is imperative that patients with pudendal neuralgia receive adequate pain management because the pain related to this illness can be intense.
Treatment depends on the reason for distress to the nerve. Once the cause is not obvious patients are advised to test minimal invasive and least risky therapies initially.
Physical therapy which includes myofascial release and trigger point therapy internally with the vagina or rectum assists with relaxing from the pelvic floor, particularly if pelvic floor dysfunction is the reason for nerve irritation. If no improvement is found red carpet to 12 sessions, nerve damage or nerve entrapment might be considered.
Botox is now used in medical settings to relax muscles and shows promise when injected into pelvic floor muscles; though finding a physician skilled at this treatment is difficult.
Pudendal nerve blocks utilizing a long-acting analgesic along with a steroid can help to eliminate the nerve inflammation and therefore are usually given in a series of three injections four to six weeks apart.
If physical rehabilitation, Botox, and nerve injections neglect to provide adequate relief, some patients opt for pudendal nerve decompression surgery.
There are three published approaches to pudendal nerve decompression surgery but there's debate among members of the pudendal nerve entrapment community regarding which approach is the greatest. Because there are advantages and disadvantages to every approach, patients face considerable confusion when deciding which type of surgery to select. Since there are merely a handful of surgeons on the planet who perform these surgeries, most sufferers have to travel long distances for help. Moreover, the recovery period is often painful and takes between 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 and helps to avoid a few of the side effects of medications. Others pursue a choice of a neurostimulator either to the sacral area or straight to the pudendal nerves. These are relatively recent therapies for pudendal neuralgia so it's difficult to predict success rates. Some pudendalites have devised ingenious contraptions for pain relief which range from u-shaped cushions cut from garden pads up to balloons full of water, frozen, and inserted in to the vagina. Most have a popular cushion for sitting and lots of have special computer set-ups for home and office use within order to avoid sitting. In most cases, jeans really are a no-no, so patients revise their wardrobes to include baggy pants and baggy underwear - if they're able to tolerate wearing underwear.
Clearly more research is necessary to find effective techniques to better manage the pain and debilitation of pudendal neuralgia. On the other hand, friends and family close to anyone who has this devastating illness play a huge role in assisting patients cope, thereby maintaining the highest quality of life possible. Support, love and understanding have primary importance for all those struggling with this affliction.
