Health Organization for Pudendal Education

Today I had my first rectal pelvic floor massage again.
the first thing I noticed was that the coccygeus muscle was painful and knotted. we did accupenture on this muscle today. the pain / pressure is a little bit worse..

Could pudendal neuropathy be the cause of this pain in this area? my muscle relaxes but immediately goes back into hyperactivity. my PT don't think i have pudendal neuropathy but i'm strunggle with 5-6years with chronic pelvic pain allready ...

my symptomes :
--------------------
- Chronic pelvic pain in penis , burning shocks in urethra , scrotal and anorectal pain with urgency to have a bowel movement
- IBS ( chronic diarrhea / flatulence )
- Tenesmus ( constant urgency to have a bowel movement )

Therapy :
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- cystectomy in 2022 for interstitial cystitis
- levator ani syndrome / pain on puborectalis
- small fiber neuropathy in 2022 from skin biopsy
- chronic widespread pain with central sensitisation

Marky wrote: ↑Wed Apr 03, 2024 3:19 pm Could pudendal neuropathy be the cause of this pain in this area? my muscle relaxes but immediately goes back into hyperactivity. my PT don't think i have pudendal neuropathy but i'm strunggle with 5-6years with chronic pelvic pain allready ...

my symptomes :
--------------------
- Chronic pelvic pain in penis , burning shocks in urethra , scrotal and anorectal pain with urgency to have a bowel movement
- IBS ( chronic diarrhea / flatulence )
- Tenesmus ( constant urgency to have a bowel movement )

I don't know for sure, Marky, but the pudendal nerve runs alongside the coccygeus muscle.

https://www.sciencedirect.com/science/a ... via%3Dihub

And the places you are describing that you have pain are innervated by the pudendal nerve. What does your physician think? Have you had a diagnostic pudendal nerve block yet?

Violet

hi violet, thanks for reply...

my doctor thinks my pelvic pain is from my widespread pain ( small fiber neuropathy ) and that i don't need to search for "what is hurting me".
they think it's my autonomic nervous system like hypogastric and other nerves are the issues.

i have multiple pain syndromes in my pelvis like interstitual cystitis ( cystectomy 2022 ) , irritable bowel syndrome , central sensitisation and small fiber neuropathy.

still bo nerve block in the pudendal

Marky,

In my experience, PN can cause the pain you describe. I suppose it could also be muscular. If your pain is primarily muscular, I think you will see at least some improvement through the PT within a few weeks.

Stephanies

i'm having chronic pelvic pain since 2019 , and a cystectomy in 2022 for IC/BPS and still have pelvic pain... i tried medication for nerve pain but still pain

my symptomes are :
- chronic pelvic pain
- chronic scrotal pain ( mostly right side )
- urethra pain / rectum pain
- feeling like something stuck in my rectum
- tenesmus ( the feeling i need to poop all the time )
- IBS symptomes like abdominal pain,cramps,diarrhea,constipation

my EMG was normal for motor function but my skin biopsy was positive for small fiber neuropathy / sensory

It's pretty common for people with pudendal neuralgia to have more than one medical problem. You could potentially have small fiber neuropathy and pudendal neuralgia. But you also had that major surgery that could have caused scar tissue to form in your pelvic area. You have a lot of things going on so I think you might want to consider more diagnostics such as a pudendal nerve block or at least seeing a pudendal neuralgia specialist who can help you sort out whether your pudendal nerve is part of the issue. Have you had an MRI of the pelvic area yet?

Violet

i started with pelvic floor therapy 2months ago and we did relax therapy and exercise. we started 3 weeks ago with internal work, she mention that my ischiococcygeus/ coccygeus was verry spastic and painfull. we did accupenture in those
muscles with zero to little relief..

yes i had a cystectomie for relieving urgency/frequency but it didn't work for the pain.

i tought that small fiber neuropathy is the crux for neuropathic pain...

I think i have pudendal neuralgia because it's going in from 2019 with zero relief on pain ... if it was a musculair issues then i think it was allready solved in 6-12months... other side its says that small fiber neuropatht is prevelent in IC/BPS and
complex pelvic pain , IBS and other painfull syndromes...

Marky,

From what I have gathered from PTs, relief should be significant in the first three months of therapy. I also think an MRI of the pelvis is a good idea to rule in/out other conditions and also to look at sacrum, the lowest part of the spine, especially the sacral nerve roots. Some end up finding out we have issues there like scarring or Tarlov Cysts. Your doctors might also be willing to order a lumbar MRI and sometimes there’s an issue that can be found there that could potentially explain PN symptoms (annular tear, tethered spinal cord, etc.).

Stephanies