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Introduction to Pudendal Neuralgia
No one likes to talk about their private parts, especially when things aren’t going well. But sometimes, let’s face it, things go wrong down there. Recently, my husband had a strange nerve sensation at the tip of his penis that would radiate down his leg into the base of his foot. Needless to say, this problem, which he self-diagnosed as pudendal neuralgia, was distressing. Nothing seemed to help and after several months of this strange sensory anomaly, he’d decided that it was something he’d just have to learn to live with.
Last year, I went to a Rolfer for sciatica and lower back pain that just wouldn’t go away and at this time, I learned a little bit about nerves through personal experience. One important thing that I learned was that nerves aren’t very well understood and the pain that they cause can be misinterpreted by the person experiencing the pain. When a nerve gets stretched or entrapped (fascial entrapment of a nerve), we really aren’t trained to recognize the sensation that it causes. Most of the nerve pain that I was having (sciatica) was due to a nerve problem, not a muscular problem. But I’d been treating my pain as a muscular issue…I spent a lot of time stretching my muscles every day trying to make myself feel better, but with no success. Then I read the book, Ultimate Back Fitness and Performance by Stuart McGill, PhD and learned that what my back and my sciatic nerve really needed was rest. I needed to find physical positions and movements that didn’t aggravate the nerve…namely pain-free positions and movements. The goal was to position my body and move my body in a way that didn’t cause me pain or discomfort. Only then would my nerves stop screaming at me.
And you know what? That worked. I’ve been without back-pain for about 8 years now. And this experience with back pain help my husband cure pudendal neuralgia.
When my husband started having this strange sensation that went from the tip of his penis to his foot, I immediately knew it was a nerve issue. Women often develop pudendal neuralgia or pudendal neuropathy after childbirth, but men can develop the problem as a result of constipation and chronic straining that puts stress on the pudendal nerve. What was weird about his problem was that he wasn’t experiencing pain, but the nerve sensation that went from the tip of his penis to the bottom of his foot was just weird and distracting. It gave him anxiety because it didn’t seem like it was okay for it to be happening. We decided that a nerve in his back might be compressed or irritated. It’s possible for nerve signals to get crossed and for a nerve that goes to the foot to rub up against or get entangled with the main nerve in the perineum, the pudendal nerve. So we decided to take a wait-and-see approach on the pudendal neuralgia symptoms rather than going to a doctor for fear that the doctor would make things worse.
A few weeks ago, while traveling in Mexico, my husband and I attended a temazcal in Guanajuato, Mexico. The goal of the temazcal was undefined. The last time we’d done a temazcal, we felt absolutely fantastic for several days. So we thought we’d give it a try again. This time, when John walked out of the tent, his pudendal neuralgia was gone. GONE. And 7 years later, it’s still gone.
That’s not to say that extreme heat and humidity would help everyone who has this problem, but for those who are looking for conservative pudendal nerve treatments it’s worth noting.
Pudendal neuralgia can be caused by the fascial entrapment of a nerve and Rolfers work with this kind of problem all the time. Rolfing is a type of therapy that feels a lot like massage, but it’s different than massage in that practitioners are working with fascia and nerves rather than muscles. Often, Rolfers will give patients instruction on how to walk or stand differently to relieve pressure on nerves.
Prolotherapy is a regenerative injection treatment that can help with spinal issues by repairing damaged or weak tendons and ligaments. By treating the weakened joints in the sacrum, spine, or pelvis, nerves that are pinched or entrapped can sometimes be “set free”. This type of treatment involves injections, so its much more conservative than going through surgery to fix the problem.
Neural Therapy is another injection-based alternative cure for pudendal neuralgia. This treatment typically involves a combination of dimethylsulfoxide (DMSO) and lidocaine into an area around irritate nerves to reset nervous tissues that are misfiring. Neural therapy doctors are available all over the world to provide this type of treatment which is minimally invasive and low-risk in comparison with surgery and even pharmaceutical treatment for pudendal neuralgia.
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