Pudendal Nerve is one of the main nerves of the pelvic region that supplies the pelvic floor muscles, the anal sphincter and the clitoris in people with vaginas and glans penis in people with penises. There can be various causes for pudendal nerve injury/irritation/compression.
Some of the causes of Pudendal Neuralgia are:
Injury to the nerve:
- During childbirth, abdominal/pelvic surgeries
- Injury to the pelvic bone
𝗖𝗼𝗺𝗽𝗿𝗲𝘀𝘀𝗶𝗼𝗻/𝗶𝗿𝗿𝗶𝘁𝗮𝘁𝗶𝗼𝗻 𝗼𝗳 𝘁𝗵𝗲 𝗻𝗲𝗿𝘃𝗲:
- Infection (UTI/Yeast), Inflammation (Endometriosis)
- Pelvic floor muscles overactivity
𝗘𝗻𝘁𝗿𝗮𝗽𝗺𝗲𝗻𝘁 𝗼𝗳 𝘁𝗵𝗲 𝗻𝗲𝗿𝘃𝗲:
Thickening of ligaments, pelvic floor muscles and remodeling of the Ischial Spine (part of the pelvis) due to repetitive loading of these structures in certain sports such as horseback riding.
Impingement of the nerve can happen at various positions:
- Underneath the Piriformis muscle
- Between the Ischeotuberus & Ischiococcygeus ligaments of the pelvis
- In the Alcock’s canal
- Entrapment of the terminal branches
Common symptoms are pain with sitting in the distribution of the pudendal nerve, burning sensation in the vulva, pain in the clitoris/tip of the penis, etc.
However, there are other nerves in the region that all supply a small part of the genital region and overlap with pudendal nerve supply. Therefore, an injury of these nerves could be mistaken for Pudendal Neuralgia. The nerves that can get irritated or injured, secondary to any abdominal or pelvic/hip/spinal injury, hernias etc. are:
- Ilioinguinal nerve
- Genitofemoral nerve
- Obturator nerve
- Posterior cutaneous femoral nerve
Therefore, anyone who presents with pelvic pain/burning/itching sensation must be assessed carefully.