Health Organization for Pudendal Education

Hi, i have been experiencing what i think to be pudendal pain for 6 weeks, this is following injuring my back again at the end of january. I have a 3 year history of sciatica and what i would call altered gait. I tend to walk with a slight limp. My lumbar MRI is showing several lumbar disk bulges, with herniation at L4/5 , bone spurs at several levels and stenosis. The majority of my leg pain issues are much improved however this new pain is knawing away at me. Its on the same side as my sciatic symptoms, and between my back passage and scrotum. It can be burning, aching, with electric shock like sensations in the end of my penis. I cant concentrate with it. Driving, kneeling or sitting for any length of time seems to make it worse. Usually it wont kick in untill the next day. especialy if ive been driving. I have an appointment with a neurosurgeon tomorrow about my back and was wondering if anybody else has been in the same situation. This past 18 months i have been overdoing it a bit., renovating a house, and also working full time. Thank you for taking the time to read.

Welcome to the Forum, Steven. Pain in the scrotum can be pn, and the burning sensation is typical of nerve pain. Sitting pain is very common with pn, and it sounds like you might have that if you have pain when driving. So, it could be pn. The pudendal nerve passes through the spine at the S2, S3, and S4, I think, but some doctors have been exploring a possible link between lumbar issue and pn. Also, Tarlov cysts on the sacrum have been linked to pn. A physical therapist who is knowledgeable about pn can be helpful with diagnosis. What did the neurosurgeon think was going on?

April

Hello!
Since you have LB problems and you are not walking properly i'm almost 100% sure you have unstable pelvis. The spine and human body overal is like 1 machine. If 1 part is no working normal then other parts suffer too. This can cause numerous problems including pudendal nerve problems. After all if you have the real reason why this is happening, only then you can trully heal. I dont think neurologist or neuro surgeons can help you - they can only prescribe drugs and do surgery (which i never recommend).
Find good corrective chiropractor . I'm repeating - GOOD. If you live in California i can give you the name of the best.
This is only my opinion.I'm not a doctor, just a simple massage therapist.
Good luck !

Hi April, thank you for your reply,

The neurosurgen was non commital, which i half expected. She felt that there may be piriformis involvement and felt physical therapy was the way to go for now. I also have an appointment with the pain clinic at the end of the month which may help. As my sciatic symptoms apear to be improving surgery to decompress L4/L5 is not needed , however i see her again in 6 months. I do have a lot of low level pain that seems to move all over the place, around my hip, back of my thigh, and my buttock. I feel i have been compensating a lot over the last 3 years since i origanally hurt my back and developed sciatic pain, so i think i think the physical therapist input will be good right now. Im hoping it might be just whats needed. Fingers crossed.

Steven.

Thank you also -unfortunate- for your reply. yes i do feel my slight 'limp' is a contributing factor. Combined with my excessive workload , renovating a house over the past 18 months, and working full time as a nurse, i think its all taken its toll. To be honest as work was progressing in the house i was starting to feel a dull ach now and again, but it was fleeting and seemed to resolve with walking.

Steven

Do some diaphragmic breathing with a physiotherapist. Ask her to dry needle you and start nerve flossing exercises. Then start Pilates with an experienced instructor(Reformer Pilates). I started with pudendal pain and then sciatica. You can also have prolotherapy while doing pilates. The physical therapists do not do the same techniques and the chiropractors do not understand the problem so it is wasting your money. Go to an experienced Physiotherapist(Oceanside Physiotherapy Stratham NH I am seeing). Calming the nervous system down first with dry needling and breathing will help you exercise.
Understanding , the aches and pains will come and go as you stabilize your core.