What is Pudendal Neuralgia?
Pudendal neuralgia, also known as Alcock’s syndrome” or pudendal canal syndrome, refers to pain originating from irritation of the pudendal nerve. The pudendal nerve originates in the pelvis and provides sensory and motor innervation to the muscles and tissue of the pelvic floor. It has 3 branches that innervate , the front, middle and back of the pelvic floor. Irritation of one of the branches or the nerve root as a whole can cause pain in its respective area, including the rectum, anus, urethra, perineum, clitoris, mons pubis, vulva, labia and lower 1/3 of the vagina. It also may cause referral of pain or altered sensation down the back of the leg. The International Pudendal Neuropathy Association estimates the incidence of this condition as 1/100,000, but it is reported by clinicians treating this condition to be much higher. The pudendal nerve can be injured or become irritated as a result of the following:
Tension or traction of the nerve that may occur with activities such as chronic constipation and or straining with bowel movements, childbirth, organ prolapse and strenuous squatting especially if repetitive.
Compression of the nerve that may occur with activities such as cycling, horseback riding, prolonged sitting or even a fall on the tailbone.
Entrapment of the nerve due to tight soft tissue, including the muscles and associated fasciae as well as degenerative joint changes.
Chronic infections of the bladder and vagina (yeast or bacterial).
Surgical injury that may occur during pelvic floor procedures.