What could possibly be worse than struggling with a painful condition and feeling ashamed to discuss the problem due to the intimacy of its nature? Such is the case for several suff ering with pudendal neuralgia, a little-known disease that affects one of the most sensitive areas of the body. This area is innervated by the pudendal nerve, which is located deep in the pelvis and follows a path that comes from the sacral area and later separates into three branches, one going to the rectal area, one to the perineum, and one to the penis or clitoris. Because pudendal neuralgia is uncommon and can be similar to other diseases, it is often misdiagnosed, leading some to have inappropriate and unnecessary surgery. Early in the diagnosis process, it is crucially important to undergo an MRI of the lumbar-sacral and pelvic regions to determine that no tumors or cysts are pressing on the nerve. An accurate history is needed to assess whether there has been a trauma or an injury to the nerve from surgery, childbirth, or exercise.

So what exactly are the primary symptoms? The main symptom is pain while sitting. You may feel amazing in the morning until you sit for coff ee or drive to work. You get better with lying down.

Pain can be stinging, burning, stabbing, aching, knifelike, irritation, cramping, spasm, tightness, crawling on the skin, twisting, pins and needles, numbness and hypersensitivity. The initial constriction is often caused by pressure or trauma. As the nerve swells, it encounters a natural constraint. Stretching or rubbing of the pudendal nerve can also cause pudendal nerve entrapment.

What are the treatment options? One of the best treatment options for non-surgical relief for this chronic pain is the Pudendal Nerve Block. Pudendal nerve blocks are minimally invasive and can help not only provide comfort to pelvic pain, but this pain management technique can provide therapeutic relief by reducing pain signals originating from this nerve bundle. For cyclists, pudendal nerve blocks can offer a stable solution to pain associated with long-distance riding. Patients who have systemic conditions such as diabetes and multiple sclerosis may also benefit from the Pudendal Nerve Block procedure.

“This procedure is safe. The most common side effect is temporary pain at the injection site. Fortunately, serious side effects and complications are uncommon.

How does it work? A pudednal nerve block is performed with X-ray guidance to increase the accuracy and safety of this procedure.

  • You will be asked to lie on your stomach
  • Your lower back and buttocks will be cleaned with an antiseptic, and a sterile drape will be placed
  • Your physician will direct a guide needle toward the intended target area under X-ray guidance. Bony landmarks easily visible under live X-ray guidance will help facilitate safe placement of the needle.
  • A local anesthetic and a steroid medicine will be administered in close proximity to the nerve to block signals from reaching the brain. The cortisone serves as an anti-inflammatory under the assumption the nerve is inflamed or irritated.
  • The needle is then flushed and withdrawn, and a dressing is placed over the point of the needle entry.

Are there any risks? This procedure is safe. The most common side effect is temporary pain at the injection site. Fortunately, serious side effects and complications are uncommon.

Don’t suffer in silence any longer! Friends, family and close loved ones can play a huge role in helping you cope, thereby maintaining the best quality of life possible. Remember to talk to your University Pain Medicine Center Physician to seek the solution you desire!

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