PUDENDAL NEURALGIA VS. PUDENDAL ENTRAPMENT
Pudendal Neuralgia refers to pain along the distribution of the pudendal nerve including the clitoris or penis, anus, and perineum. The pudendal nerve can be irritated from inflammation, tight/spastic pelvic floor muscles, or compressed from prolonged sitting or poor sitting mechanics. Pudendal Nerve Entrapment (PNE) may present with similar symptoms of Pudendal Neuralgia but in the case of Pudendal Nerve Entrapment the nerve is trapped or damaged structurally (via ligament, bone, etc.). While both cases may have increased pain with sitting, Pudendal Nerve Entrapment pain is unrelenting and may not change with position. A very small percentage of the population actually have an entrapped pudendal nerve and surgery may be the only relief.
PUDENDAL NEURALGIA VS. PELVIC FLOOR DYSFUNCTION
Pudendal Neuralgia and Pelvic Floor Dysfunction are not the same and terms should not be used interchangeably. These conditions may have overlapping symptoms, however, in the case of Pudendal Neuralgia there may be less bowel and bladder associated dysfunctions and the classic symptoms of Pudendal Neuralgia include:
- Pain is more severe in sitting
- Pain is absent or significantly less when lying down
- Pain is less when sitting on toilet vs chair
- Sensation of foreign body in the rectum or vagina
- Pain does not wake at night
- No sensory loss on clinical exam
- Positive response to Pudendal Nerve Block
Both Pudendal Neuralgia and Pelvic Floor Dysfunction will improve with physical therapy. Physical therapy intervention is similar for both conditions especially when tight or spastic pelvic floor muscles are the reason for the pain, however with PFD there may be more focus on bowel and bladder related symptoms as well.