Health Organization for Pudendal Education

Can someone give me some advice? I went to a physical therapist because I believe I have pelvic floor tightness and possibly some pudendal neuralgia. The first visit was more of an evaluation and she told me she didn't think I had pudendal neuralgia but my muscles on the right side of my vagina are tight. As she did the evaluation, I wasn't in any horrible pain when she pressed on areas. I also didn't have any pain after the evaul and things actually seemed to be improving with the 20 min walks and two leg stretches she had me doing. Well today, I went back and she said my right hip bone is higher than the left and all those muscles are tight and contributing to all of this. She is giving me more stretches and she also did some massage and stretching in my vagina. She says I seem to be responding already to the stuff, but I am in pain now... Shortly after my session with her I am in pain. In my hip and the back of my leg running all the way down and when sitting a little bit. I just worry this might make things worse for me.... She also told me today now that I might have pudendal neuralgia and that my tightness is deep like near the Alcocks canal... So that scares me because I feel like she doesn't know if I have it or not now. My question is does PT hurt no matter if you have PN or not?? And also, do you think I should keep doing this?? I'm just so afraid I'll make my issues worse if I keep up with this!!! I can still sit, but it's a dull ache, almost like a tooth ache.

Ashley,

PT can hurt, both while you're receiving it and/or later with a delayed response. I left my first physical therapist, because I sensed that she was making it worse (she pushed areas directly on and around the nerve). I took a couple of weeks off from her and was much better, which supported my sense that she was making it worse. The pt I switched to had much more experience with pn, and she avoids doing anything that hurts during the session or that seems to have a delayed pain effect (I always give her reports on my pain levels since the last visit). So, if you sense this is making it worse, you could take a couple of weeks off and see if you are better without it. You could also try to find another physical therapist. There are some listed on this site, but you can also ask obgyns and other pelvic doctors for suggestions.

April