Pudendal Nerve Puns

I’m six days into my switch. After the first dose I felt a bit groggy, felt fine days 2 3 4 but yesterday and today I’ve felt weird. I thought I was gonna get constipated, I didn’t for the first couple days to my surprise and I felt fine and thought it was mad I wasn’t affected by the switch. It also doesn’t make me tired which I thought was gonna happen. Yesterday and today I’ve had a constant headache, dehydrated, nausea but hungry and almost like constipation / indigestion but I can still go in small amounts. Did anyone else experience this during their switch? It’s nothing I can’t handle as long as this cures my pain and side effects subside at some point but I’m just curious to know if this is normal?

Has anyone possibly had an ultrasound or MRI(or EMG) to specifically show the pudendal nerve and check for some form of entrapment. I have no idea if this is any kind of cause, I am just throwing out suggestions and trying to investigate all potential avenues. I've been doing physical therapy for over a year, stretches, and had trigger point injections intrarectally into the pelvic floor muscles without much success or relief(I probably am worse). I also have certain symptoms that would seem to point to a neurological dysfunction of some kind like intense tingling down the legs and in the feet which is correlatively triggered when having bowel movement especially, but sometimes just sitting. From a paper published in April of this year on 'Pudendal Nerve Entrapment Syndrome' in the NCBI journal:

"Anatomy of the Pudendal Nerve:

The pudendal nerve emerges from the S2, S3, and S4 roots' ventral rami of the sacral plexus. It carries sensory, motor, and autonomic fibers; however, an injury to the pudendal nerve causes sensory deficits more than motor. It courses between two muscles, the piriformis and coccygeus muscles. It departs the pelvic cavity through the greater sciatic foramen ventral to the sacrotuberous ligament. It passes medial to and under the sacrospinous ligament at the ischial spine level to re-enter the pelvic cavity through a lesser sciatic foramen. The pudendal nerve then courses in the pudendal canal, which is also called the Alcock canal. The three last branches of the pudendal nerve terminate in the ischioanal fossa. These are the inferior rectal branch, perineal branch, and dorsal sensory nerve of the penis or clitoris. However, there are case reports which have shown variability in the anatomy of the pudendal nerve.[2][3]"

I've been diagnosed and un-diagnosed with IC for years, but my main symptoms are intense urethral burning, painful pressure points in my vagina, bladder stinging/burning sensations, issues wearing tight underwear or pants, and lots of urethral pain during penetration. I've done pelvic floor PT and I take 300 mg of gabapentin daily.

I recently saw a new urogynecologist who wants me to do pudendal nerve blocks. She wants to do the injections through the vaginal wall 1x per week for 6 weeks. Never been diagnosed with pudendal neuralgia, but I'm desperate to feel better. It's been years.

Anyone have experience with transvaginal pudendal nerve blocks? How's the recovery? Does it help with urethral pain and penetration? Do you lose clitoris sensation? I can't find good answers online anywhere!

I had chlamydia back in February burning sensations went away . But weeks later I started getting these sharp deviating burning pains down the middle of my penis that would come and go randomly maybe last 2 secs. I was put on more antibiotics. Symptoms went away 2 weeks later they came back. This went on for 3 months . Now I haven’t had these pains for the last 4 months but I have had chronic testicle pain what could this be ?

Long story short, about almost 6 months ago now I think I hurt my penis somehow, or masturbated in an odd way that set off some sort of nerve issues within my penis. There is a lack of sensation and sometimes there were pains in the penis.

As time went on, usually after I masturbate or even now when I don’t, I am getting bad pains in my tail bone, or thereabouts. Also hurts to sit and even stand and sometimes just about anything, around the anal region and levator ani, I believe.

The pain kind of travels, sometimes my buttocks feels super sensitive and painful, almost like mini spasms? It’s causing me distress and I’m taking close to 1200 mg of ibuprofen a day. What should I do?

Nerve suffer becouse muscles tigh or similar?

I have had mild ED and perineum and sciatica irritation for 3-5 years from sitting too much, but never once experienced a sudden injury or excruciating pain that people talk about, just pudendal discomfort that gradually worsened over the years to the point where the pain is now moderate and goes along with tingling and occasional spasms. Can **permanent** nerve death ONLY happen from a sudden severe injury, or can it even happen from extended irritation for many years? I don't know how nerve work and always assumed a nerve would have to be suddenly and violently injured to cause any amount of irriversible nerve death, but my nurse told me its possible for long term nerve strangulation to cause some permanent nerve death even if there was never excruciating pain or sudden blunt injury.

My PT said it may be a couple months before my nerve becomes loose enough for PT exercises and I should only stretch right now, but stretching and breath work alone isn't calming down my nerve fast enough. How can I relax and loosen the pelvic floor while also giving the pudendal nerve proper rest and nutrition to heal once it becomes less tight?

Do you have a bulging perineum, issues with your pudendal nerve, mild perineum and penis spasms, or at least weakness and ED? You may mistakenly think that because your perineum is hard and bulges out, that it has too much muscle tone from constipation, or other straining. This is not true. It looks hard because it is too tight, and it looks big because the muscle has dropped, NOT because the muscle is too strong. Straining does not strengthen anything. Straining and constipation is a RESULT of a weak pelvic floor, and kegels can help with constipation and ED, in addition to breathing exercises and hip, core, and glute strengthening.

The reason why this is so important is many physical therapists have said that nerve entrapment in the Alcock's Canal is similar to other areas of entrapment, but can have different symptoms and can be harder to rehabilitate vs other areas where the pudendal nerve can be entrapped. So I'm wondering if different exercises or stretches are necessary vs other types of nerve entrapment?

I notice I've been getting 20-40 boners a day the past 6 months. Any image of attractive women of Facebook, messages I get, or brief thoughts, anything will instantly make me erect. It's bad because it stresses the nerve and makes the ED worse. I need to just relax the nerve for 6 months with no stimulation and continue pelvic floor stretches. On the other hand, maybe I've always gotten frequent erections, and its just more noticeable now because it causes discomfort? Is 20-40 times a day average for a guy in his 20s? (apart from the fact that they're soft and hard to maintain because of the trapped nerve. But its not "hard flaccid". It is a true erection, but doesn't maintain or feel as rigid). Any tips for avoiding sexual stimulation?

35 yo white male. Dx/ persistent depressive disorder, GAD, ADHD. Rx: Lexapro 20 mg 1x/daily, Adderall XR 10 mg 1x/daily, meloxicam 1x/daily 30 days, Cyclobenzaprine PRN. No surgeries, hospitalizations, or injuries in the last 10 years.

Prior to spring 2019, I exercised 3-5 times per week, usually weight lifting and low impact cardio exercise. I’ve always avoided cycling because that motion causes an uncomfortable sensation of something rolling over and popping on my hip joints (more the right than the left). My job involved (and still involves) a lot of sitting. In spring 2019 I started to notice a dull, aching pain in my hip joints, made worse by prolonged sitting. I moved to a new city and new job, and noticed the hip pain and discomfort worsening over the next few months.

I began to notice more lower back pain, discomfort in my right hip and leg when lying down, and a really bothersome issue: the area between my testicles and anus felt tense, like an overworked muscle, and my penis (especially along the underside, frenulum, and glans) felt significantly more sensitive than normal. Not painful, just more sensitive; if 0 is normal sensation, -10 is complete numbness, and +10 is unbearably heightened sensitivity, I was sitting at about a +6. This made sexual activity uncomfortable at times, as pleasurable sensations were almost uncomfortable, and my orgasm control was nearly gone.

Over the course of the following year, I began to notice first a dull ache radiating up the back of my right leg, from my calf to my buttock. This worsened over time, to the point that I’d experience tingling and numbness along the back of my right leg, made worse by prolonged sitting or walking. Still experiencing the heightened sensitivity in my pelvic area and genitals (although this has improved overall, and comes and goes), and still the tight, dull painful feeling in my hips. I also feel a dull achy pain in the arch of my right foot.

I saw a chiropractor for two months with little improvement. I then saw an orthopedist who ordered X-rays and MRIs of my hips; no abnormal results. I saw an electrophysiologist who said he was “99% sure” I have piriformis syndrome.

Since then, the only thing I have found that improves the pain and discomfort in my hips, pelvis, genitals, and leg is deep tissue massage of my right leg.

Any ideas on what this all is? How to treat it?

So I have been diagnosed with pudendal nerve entrapment. Now the question is does this have a solution? From what I read it looks quite bleak, but I don't know much. Thanks for any info or experience. Hugs to all. This s*** is tough.

Can any of you provide me with these studies because try as I may I just can’t find them, but I’d really like to read them.

I am a 23 F who developed pudendal neuralgia after getting married. I am currently being seen at Northwestern Hospital in Chicago for this condition at their speciality vulvar clinic. While waiting to be evaluated for other treatment options, I was prescribed gabapentin 100mg (I have a tapering up schedule ).

I am a little worried to take the drug and was curious what I should expect and if anyone found relief from their pelvic nerve pain with this drug? I have been struggling for several months with this and would appreciate any advice a great deal.

I just want my life back.

I posted several months ago about the pros and cons of getting a pudendal nerve block for interstitial cystitis/vulvodynia after my uro gyn suggested it (with imaging) and people were very helpful! So I got the procedure done almost 3 days ago and I don’t feel any improvement at all (but the doctor said I may not feel any improvement for 3-6 weeks), but my main concern is: how long is it normal for my butt cheeks to be very sore after the injections? Additionally, my physical therapist told me that if my genital area and vagina didn’t feel numb right after the procedure, then that means either that the procedure wasn’t done in the right place or it rules out that the pudendal nerve block plays a role in my pain. I was not at all numb in the area after the procedure. Also, what does nerve damage feel like? Since the procedure I’ve been feeling tiny second-long pinches/stings on my limbs and wondering if that’s just me being scared or actually something? What are you thoughts?? All welcome

In case anyone is curious about the pathway and distribution of the nerve

https://www.youtube.com/watch?v=sz1LDExhitw

Hi all, I just recently had some Injections done in several locations of the pudendal nerve in the sacrum and hamstrings. The first couple of days post injections (cortisone and nerve block) I was feeling pretty good, some overall improvement in my symptoms. But now on day 4 I have realized that I am having pretty severe difficulty with ED. Not sure if the nerve block resetting those muscles has caused things to be a little weaker or if it’s potentially a side effect from the medication injected?

Hello. I have been having chronic anorectal burning pain for the past 3.5 years. It only occurs during defecation and lasts all day after. My doctor seems to think it's pudendal neuralgia. It is localized in the anterior area.

I want to ask has anyone experienced or know someone who experienced something similar? Has anyone tried a nerve block? what are the side effects? how long does it work?

I'm a 28 years old male.

I was studying reproductive anatomy and as I was doing my AnKing cards, there was a card that says "postpartum urinary retention can result from pudendal nerve palsy from pelvic floor injury" and also a card that says pudendal nerve injury can cause stress incontinence as the motor control over external urethral sphincter is lost.

So which one is it? If a person gets their pudendal nerve injured during delivery, do they get urinary incontinence or urinary retention?

Thank you.

I [28 M] have all the symptoms of pudendal pain on the left side: random urinary urgency, pins and needles and golf ball in perineum, sitting pain absent on toilet, mild stinging at the tip of the penis. I seem to have lost some sensation behind the scrotum, left side of perineum and upper thigh. Scratching the area is painful and I use a bidet to clean up after defecating and I notice when the water hits the left buttock, it's painful like stabbing needles consistent with sensitized nerves. When I sit, my sit bones and the area between the leg and groin feel raw and exposed. My underwear and clothes brushing against the area causes noticeable discomfort.

I'm going a little crazy thinking that I'll never be able to sit without pain again. I don't know when this started but I first started noticing it when I lost my job a few months ago. The only thing I can think of that could have caused it is prolonged sitting. I've worked from home in 2020 and sitting 16+ hours a day seems to have contributed to some kind of nerve compression. I already had sciatic injury and weakness in my left leg from a herniated disc years ago and this seems to be a new injury on top of that on the same side.

Right now I'm avoiding sitting at all costs and just standing all day. I've been walking as much as possible, 10+ miles every few days. The pain lessens when walking but it comes right back when sedentary. I notice my anal sphincter is always flexed so there is a lot of tightness and the stress of being out of work is probably also contributing.

I really hope this goes away because I can't imagine how I can function if I can't sit to drive or work without discomfort. I've been using lidocaine to numb the area which works only sometimes. I'm thinking of going to the ER soon for a workup.

It seems this is more commonly diagnosed in Europe and I've read about potential spontaneous recovery with self-care (avoiding sitting) to curative effects from a series of 3-4 pudendal nerve blocks to full-on decompression surgery usually reserved for the most severe cases. Does anyone have stories of recovery from diagnosed pudendal nerve pain?

I’ve posted in here a couple times describing my issues, but to recap: I had surgery in September 2020 for suspected endo. My surgeon did find a small amount and burned it away. The following month I started having lower left pelvic pain that impacted my bladder/pressure and urethral/clitoral “shocks” that were TERRIBLE. Everytime I would pee, the shocks would then follow for 15 mins to an hour. I honestly feared going pee. I was told her to see a pelvic floor therapist and have gone for 6 sessions so far. She has changed my world. I can’t thank this group enough for giving me guidance and the push to go see one. I’m still experiencing some pain/pressure here and there and much smaller shocks if I get up to pee before bed, etc but nothing like before. My PT suspects I have a pudendal nerve issue. She thinks from my endo surgery (and my previous galbladder and appendix surgeries) that the adhesions beneath the skin have fused on to parts of the muscle, some of which are tugging and putting pressure on the pudendal nerve. She’s been doing tons of abdominal and pelvic massage to loosen the adhesions and that has helped tremendously. She’s also done a great deal of internal work, loosening the level 2 muscles near the urethra. Still a lot of work to be done, but wondering if anyone else is dealing with a pudendal nerve issue and how you’ve coped and moved forward? Thanks!

Did anyone do a pudendal nerve block or ganglion impar block for Hard Flaccid (HF) and what were your results?

Got my big surgery packet in the mail and this was listed as one of the things happening during my surgery. I looked it up and it sounds like a good idea! But of course I am skeptical of everything lol.

So has anyone had one done? What was your experience?

Has anyone here recovered from pudendal nerve entapment?

My doctor suggested trigger point injection, 6 injections in total. Do you have experience in this treatment? Is it useful? Thanks a lot in advance

Previous post: https://www.reddit.com/r/PelvicFloor/comments/o0i4br/update_prostate_massager_injury/

So this is what's been going on. The good news is my pelvic tightness and pain is improving, but what develops once my pelvic floor actually relaxes is devestating. Basically it seems my pelvic floor has been extremely tense in an effort to protect myself from nerve pain.

for the past 3 nights, when I go to lie down, I get an intense pulsating buzzing sensation that goes from my sit bones down into my penis. As my pelvic floor relaxes the intensity of this buzzing intensifies to the point where it feels like it's vibrating at an extreme frequency - pain spasms throughout my genitals, glutes and lower back. It's debilitating, and I'm unable to sleep.

last night around 1am I decided enough was enough and went to the emergency room. They listened to me and agreed it's likely pudendal neuralgia and that there wasn't a ton they could do to help except give me pain meds. They gave me morphine, oxycodone and gabapentin.

It took the edge off the pain but I'm still getting that deep buzzing vibration emanating from the nerve.

It's hard for me to imagine what life is going to be like going forward if this continues to happen ever time I lay down. When I stand up, almost all of the symptoms disappear.

Right now I'm exhausted.. and I won't be able to see the pelvic floor PT until July 22nd.

I am the type who really tries to stay away from medication, but there's no way I can handle this pain without help. It's way too intense. I just need to sleep. I got around 3 hours of sleep the two prior nights, and only one hour last night.

It all seems very bleak right now, and I'm pretty sure I'm having a full blown anxiety attack. Trying to calm down. This is not the update I wanted to make.

I believe I got this from doing wide squats. I saw there are exercises called nerve flossing. Meaning you can work the nerve out (according to the theory) I started doing narrow jumps , lunges , and bends , everything narrow, i have relief , pm me if you want to chat about anything . Comment how you think you received this and I want us to work together ,

Edit: Not saying i’m cured just yet , I don’t have any symptoms but hopefully this relief will be permanent and we can work together with this, us sharing our attempts is more info for all of us i feel

Edit: I did one more thing before that, just in case it’s vital, I deep squatted and belly breathed, when I did that i felt the pelvic floor smash against my bones like there wasn’t enough room, I also pooped in that deep squat, then I noticed if I deep squatted with my legs wider , the pelvic floor didn’t smash against the bones when i belly breathed, so I stayed in a deep squat wide, i felt anus just wide open and sat in it a few times for about a minute at a time. So I would say there were 2 things I did, the narrow exercises and wide deep squat

Sorry for back to back posts haha, I just want to keep each one focused! But I kind of want to do an MRI to take a look at my pudendal nerve, because even though I didn’t have this condition start off with any pain, I now have pain in a lot of the locations that are enervated by this, particularly the location near to my perineum, can be quite painful and sensitive in a really bad way.

I am wondering what your experiences are with getting this done, how much it can cost, and what the test can show?

One of my other main questions is can this kind of imaging show if there is an infection in the area? Not sure if an infection is one such thing that could compress a nerve or irritate it like this, and while all my tests come back negative for infections, I’m still not fully convinced I don’t have an infection these tests just aren’t catching. Thanks!!

My uro-gyn recommended a pudendal nerve block since I’ve been in pt for 2 years. She said it is a treatment that might relieve pain. (I’ve had nerve blocks and Botox for migraines in the past so I’m familiar with how they work). She referred me to a pain doctor and I had a consultation and she said she would use imaging to make sure she does it in the right place. I asked how long it would last and she evaded the question. She said sometimes it works and sometimes it doesn’t. I saw my pt the next day and she said she is very frustrated that pudendal nerve blocks are advertised by doctors as a treatment. She said they are more diagnostic than anything. She said if I feel numb in my genital area and inside of my thighs between 2 and 6 hours after the operation, then that will verify that the procedure has been done correctly and that proves the pudendal nerve is a reason for the problems. She said people feel relief for a little bit and she does not recommend getting multiple nerve blocks because it like putting a bandaid on the issue instead of focusing on the origin of the pain. Thoughts? What are your experiences with pudendal nerve blocks?

(24 female) Does anyone here have pudendal nerve pain? If so, what does it feel like / when did it start? Did it progress? I made a terrible mistake and had a procedure that I regret every day, and among other things I think it resulted in pudendal nerve pain.

Please reach out to me if you could answer some questions I have. I’m desperate and scared

I am 8 weeks pp. At my 5 week checkup I brought up this specific pain I was feeling around my urethra/clitoral area. It feels like heaviness, blood rushing, sensitivity & pain, to that area. I can’t pinpoint what triggers it but I just got my period and tampons definitely trigger it. My doctor said that he’s not worried about this pain because it was getting better (slowly but still) and that it was due to childbirth bruising. Anyway, today I found the actual name for it Pudendal Neuralgia and the description is exactly what I’m going through. So I sent this info to my doctor because he never mentioned nerve damage due to childbirth, maybe he never heard about it?

Has anyone dealt with this and did it go away? Share your experience!

Give me some hope! I’m in pain :(

I’m six days into my switch. After the first dose I felt a bit groggy, felt fine days 2 3 4 but yesterday and today I’ve felt weird. I thought I was gonna get constipated, I didn’t for the first couple days to my surprise and I felt fine and thought it was mad I wasn’t affected by the switch. It also doesn’t make me tired which I thought was gonna happen. Yesterday and today I’ve had a consistent headache, dehydrated, nausea but hungry and almost like constipation / indigestion but I can still go in small amounts. Did anyone else experience this during their switch? It’s nothing I can’t handle as long as this cures my pain and side effects subside at some point but I’m just curious to know if this is normal?

I’m six days into my switch. After the first dose I felt a bit groggy, felt fine days 2 3 4 but yesterday and today I’ve felt weird. I thought I was gonna get constipated, I didn’t for the first couple days to my surprise and I felt fine and thought it was mad I wasn’t affected by the switch. It also doesn’t make me tired which I thought was gonna happen. Yesterday and today I’ve had a consistent headache, dehydrated, nausea but hungry and almost like constipation / indigestion but I can still go in small amounts. Did anyone else experience this during their switch? It’s nothing I can’t handle as long as this cures my pain and side effects subside at some point but I’m just curious to know if this is normal?

My PT said it may be a couple months before my nerve becomes loose enough for PT exercises and I should only stretch right now, but stretching and breath work alone isn't calming down my nerve fast enough.

Hi all, I just recently had some Injections done in several locations of the pudendal nerve in the sacrum and hamstrings. The first couple of days post injections (cortisone and nerve block) I was feeling pretty good, some overall improvement in my symptoms. But now on day 4 I have realized that I am having pretty severe difficulty with ED. Not sure if the nerve block resetting those muscles has caused things to be a little weaker or if it’s potentially a side effect from the medication injected?