Interventional options for Pudendal Neuralgia

[Dr. Jason G. Attaman]

Dear All,

I wanted to update the various treatment options we have on offer at our clinic for Pudendal Neuralgia.

1. Physical therapy prescriptions
2. Medication management focusing on nerve pain reducing medications, muscle relaxants, and custom compounded vaginal/rectal suppositories containing nerve pain medications and muscle relaxants
3. Pain psychology referral
4. Image guided diagnostic pudendal nerve blocks using ultrasound, and fluoroscopy if needed (rarely)
5. Image guided Pulsed radiofrequency treatment
6. Image guided Regenexx platelet lysate hydrodissection of the pudendal nerve
7. Image guided botox injections to the pelvic floor muscles, specifically the obturator internus and piriformis if needed
8. Image guided Regenexx platelet rich plasma (PRP) injections to the sacrotuberous ligament
9. Image guided Cryoablation of the pudendal nerve using the Epimed PainBlocker cyroablation unit; this is a full size cryoablation machine used for pain control.
10. Image guided Dorsal Root Ganglion (DRG) stimulation using the Abbot system
11. Image guided Spinal Cord Stimulation (SCS) using all available systems

All interventions are transgluteal (needle passes through the buttocks), not transvaginal. This is more comfortable and only possible with image guidance.

We have many patients travel from out of state and are used to coordinating such visits to make best use of the limited time.