Pudendal Neuralgia | Donna Sarna

What is Pudendal Neuralgia?

Pudendal neuralgia, also known as Alcock’s syndrome or pudendal canal syndrome, refers to pelvic pain originating from pathology involving the pudendal nerve. The pudendal nerve originates in the pelvis and provides sensory and motor innervation to the pelvis. It has 3 branches that, in men, innervate the penis, the scrotum, perineal region, and the anus. Irritation of the nerve root or one of the branches can cause pain in its respective area. Injury to the pudendal nerve may include nerve compression or irritation at the level of the nerve root from prolonged sitting or bending, tight tissues or degenerative joint changes leading to nerve entrapment, increased tension in the nerve from repetitive straining, surgery, organ prolapse, or pelvic infections.

What are the Signs and Symptoms?

Itching, burning, tingling, cold sensations, burning, and shooting pain in the genital and/or anal region

Pelvic pain with sitting, improved with standing or sitting on a toilet seat

Discomfort when wearing tight clothing

Feeling of fullness in the rectum

Pain with intercourse

Bladder and/or bowel symptoms (hesitancy, frequency, urgency, retention, constipation, pain with voiding)

How Can Donna Sarna Physiotherapy Help?

At Donna Sarna Physiotherapy & Rehabilitation, a pelvic floor assessment is a two-part process. The first appointment will include a detailed history and external evaluation. The physiotherapist will examine posture, movement, and the muscles, fascia and nerves, focusing on the low back, hips, pelvis and abdomen. The second appointment will include the internal examination, which includes evaluation of the skin and connective tissue of the genitals. The pelvic floor muscles are tested for muscle tone or tightness, strength, endurance, trigger points, and tissue integrity. The internal examination is performed through the anus. You are always welcome to have another trusted individual present during examination or treatment.

An individualized treatment plan is developed based on assessment findings and may include education regarding posture, diet, exercise, scar mobilization, biofeedback, manual therapy, myofascial release, visceral manipulation, and pelvic floor exercise.