Health Organization for Pudendal Education

Hi! I have had clitoral nerve pain for last 5 years. Earlier on I did have sitting pain but with acupuncture and stretches I haven’t had in years. I traveled to see a nerve surgeon bc he has an ultrasound machine to look at nerves and I wanted to see if he could see anything. He told me my pudendal nerve on both butt cheeks were inflamed (worse on right) and my genitofemoral nerve on right was inflamed. He then had me lay on back and make a butterfly one leg at a time and told me he was going to press really hard up and down my bikini lines. I had never had pain there last 5 years so it hurt bc he was pressing really hard. Then he did two lidocaine blocks one into right butt pudendal nerve and one right side genitofemoral nerve. I did feel partially numb on right side down to knee (could still walk). After a few hours both sides of my butt became sore and became uncomfortable to sit and 4 days later now I am still having sitting discomfort and both legs have some discomfort and bikini line areas are sore. I have a call with the Doctor scheduled for Friday. Has anyone had a reaction to an exam and lidocaine injection before? I just want to go back to the state I was in before this visit where my only pain was clitoral area. Can injecting the pudendal w just lidocaine on one side aggravate the whole nerve right side and left? And can pressing on nerves hard cause them to flare? Just hoping this is temporary! Starting to get upset I went. Thanks!

Hi,

Yes, an exam and a nerve block can cause a flare-up but most likely it will be temporary and will calm down soon. You could try using a heating pad alternating with gel ice packs and increase your pain medication temporarily. Or you could try some alternating hot/cold sitz baths to calm things down.

Violet

Thanks Violet. I have been doing both and taking an anti inflammatory. Is it possible if the genitofemoral nerve or the pudendal nerve he did the lidocaine injection wasn’t the source of my pain that now pain was created there? It’s been a week since injections and feel discomfort still. I know the injections were done right didn’t hit the nerve but I didn’t have pain along this nerve before. Just worried Doctor created new pain for me. I thought lidocaine only would be safer than steroid. Thanks!

I think it's too soon to come to the conclusion that you have some new permanent nerve damage rather than just some temporary nerve irritation. I don't know where along the PN your nerve block was given -- Alcock's or ischial spine maybe? There can be other nerves nearby that might be affected but I think you can stay hopeful that it is temporary. My flare-up in symptoms lasted at least a month after my Alcock's canal nerve blocks.

Violet

Thanks Violet! Gives me hope. It was injected into middle of my butt cheek.

Hi, I halve flared after every PN block I have ever had and then return to baseline within a few days to a couple weeks. I think just introducing something new into the area can be irritating to an already unhappy nerve. It seems years ago most blocks were given at the ischial spine, but I think most doctors inject into Alcock’s Canal these days. I have not had the GF nerve injected. Do you have pain he thought was from the GF nerve or was the doctor basing the need for the injection off of imaging? I hope you feel improvement soon.

Stephanies

Thanks Stephanie for replying! He did the genitofemoral nerve bc he said based on imaging it looked inflamed. It didn’t bother me but he said it goes into clitoral area and might be cause of my pain. I am not sure why both sides of my butt would be in so much pain even though he only did injection through right butt cheek unless once the nerve gets irritated it affects the entire nerve on both sides? Praying this nightmare goes away.

It could be the flare-up is causing you to tense up your muscles which then impinge on the pudendal nerve and you can get into a vicious cycle of pain that way. Are you being seen by a good physical therapist already? If not, you might want to consider having them evaluate your pelvic floor tension and see if you can get that calmed down. You could also do some alternating hot/cold sitz baths to calm down the pain.

Violet