Health Organization for Pudendal Education

I have a constant tightness in the perineum. It used to hurt when I urinated or had a bowel movement. But then I found some trigger points on my sphincter. I massaged these out and that pain stopped and it reduced the tightness in the perineum. But there is still so much tightness there. Whenever I sit down I feel this pressure on my perineum and this then causes the burning and numbness. I just can't find the trigger point for this tightness, maybe there isn't one.
I'm having pelvic floor physiotherapy and the therapist couldn't find any internal trigger points. She has diagnosed me with having a very tight pelvic floor and says I do have a lot of external muscle tightness in my abductors and hamstrings which could be putting strain on the pelvic floor muscles.

I'm not so sure, is one of the effects of PNE having tightness in the perineum? Or is it a cause?

Because of this constant tightness my orgasms don't feel right either, I don't feel relaxed like I used to before the problems started.

I have tightness in the perenium, that is the one which is causing me spasms, anal fissures and constipation. I use ditiazem ointment, nitrate for my anal fissures, they come and go often. I keep altering my laxatives because when I use the same one for a long time it is no more effective. I keep shuttling between doctors because I just dont know whether a neurologist, gastro or ortho would provide atleast some relief for my problem.

reckless wrote: I'm not so sure, is one of the effects of PNE having tightness in the perineum? Or is it a cause?

Reckless, that may be one of the most frequently asked questions on this forum and the answer is: It's hard to know for sure.

If you have a nerve entrapment it can cause tightness in the pelvic floor muscles but there is also the theory that if you have a tense pelvic floor it can impinge on the pudendal nerve and cause the same symptoms as a nerve entrapment. So many people try conservative treatments such as myofascial release and if they see significant improvement, that may indicate they just have a tight pelvic floor without a true nerve entrapment.

I already got quite a bit of release from doing the sphincter massage. But there are no trigger points left there, there's no internal ones either. I do have sore points on my inner thighs and hamstrings but I doubt these are causing me problems. Anyway, I will get rid of these trigger points and continue the stretches and if I see no improvement I will go for the nerve block on Jan 17.

Will the nerve block still bring temporary relief even if the root cause of the entrapment is a tight pelvic floor?

reckless wrote: Will the nerve block still bring temporary relief even if the root cause of the entrapment is a tight pelvic floor?

If the tight pelvic floor is impinging on the nerve it seems like the nerve block could bring some relief. I think that a nerve block is primarily diagnostic for pudendal neuralgia. If you have pudendal neuralgia then you have to figure out what's causing it because PNE is only one of the causes.

Hope your block goes well and you get some relief.

Violet M

I have no idea what is causing this tightness. Yes I am not a flexible person at all and I've got a lot of trigger points on my leg , but I'm sure they've always been there but I've never had this feeling before.

The weird thing is that when I am in pain the tightness goes away.