Pudendal neuralgia occurs when the pudendal nerve or one of its branches becomes trapped or damaged. The pudendal nerve is in the pelvic region of both men and women and is responsible for sensation in the external genitals, the bladder and the rectum.
Damage to the nerve can occur from riding a bike (this can result in compression), falling on your buttocks or another trauma such as a car accident or pelvic surgery.
People who sit still for long periods of time or go on long-haul drives regularly can get pudendal neuralgia. Likewise, athletes can sometimes get it due to repeatedly flexing their hips or lifting weights.
Women with endometriosis can get it if the endometrial tissue grows on the pudendal nerve. It can also occur after childbirth. For many women this is just a temporary effect, but for some, they find the pain does not go away.
If the person is disabled, any tight muscles or misalignment of the pelvis can pinch on the nerve. Autoimmune or inflammatory illnesses can result inflammation on the nerve.
There is some evidence that it runs in families so there may be genetic predisposition at play as well.
Symptoms of pudendal neuralgia include:
• Burning pain during urination
• Urinary retention
• Not feeling the sensation of urination when you go
• Cystitis-like symptoms, wanting to go even when your bladder is empty
• Pain when pressing on the vagina or rectum
• Pain in the perineum
• Scrotal pain
• Pain before, during or after a bowel movement
• Pain or numbness in the buttocks
• Low back pain (referred)
• A feeling of inflammation when walking or sitting.
If your pudendal nerve is trapped, it can also cause difficulties with your sex life. Women frequently report pain during and after intercourse and pain during orgasm. Men report a reduction in sensation during intercourse and inability to orgasm or pain after because of this.
Many people completely recover from their nerve entrapment but for some, it is persistent and they develop a pain syndrome, depression or post-traumatic stress disorder.