Pudendal Neuralgia

The pudendal nerve is a nerve that travels through the pelvis and is involved in either motor or sensory function for many of the pelvic organs.  It can be traumatized from an injury anywhere along the path of the nerve. It can also be squeezed and therefore become irritated as a result of pelvic floor muscles that are too tight.  This nerve carries sensory information from the clitoris, the entrance to the vagina, distal vagina and the anus.  If the nerve becomes dysfunctional it will send pain signals that seem to originate from the areas listed. Rarely does the nerve spontaneously become dysfunctional.  Most patients will give the history of an event that triggered trauma to the nerve.  Surgery, a difficult forceps delivery or a serious fall with blunt trauma can all result in injury to the pudendal nerve.  Pain originating directly from the nerve requires therapies directed to this nerve dysfunction.  The majority of the time the nerve related symptoms are actually triggered by the high tone muscles seen in patients with pelvic floor myalgia. Therefore treatment of the pelvic floor dysfunction makes the nerve pain go away.  A careful evaluation and understanding of pain disorders is necessary to determine if you have a primary nerve pathology or if the symptoms of pudendal neuralgia are actually being triggered by other problems.