Pudendal Neuralgia
If you’ve been struggling with chronic pelvic pain and are looking for relief, then look no further than the pudendal neuralgia specialists at Advanced Neurospine Associates. Our team of board-certified interventional pain experts is committed to providing comprehensive, evidence-based treatment and the highest level of care possible. With their specialized diagnostics, minimally invasive treatments, collaborative approach to patient care, and dedication to helping alleviate symptoms caused by Pudendal Nerve Entrapment (PNE), they make it a priority to help patients get back on their feet as quickly as possible.
What Is Pudendal Neuralgia and What Are the Symptoms?
Pudendal neuralgia is a medical condition characterized by pain, discomfort, and spasms near the genitals, the anus, and/or inner thighs. The cause of the condition is unclear but can involve nerve compression or damage to the pudendal nerve. Symptoms of pudendal neuralgia may range from minor discomfort to debilitating chronic pain, which can last for months or years at a time. Typical symptoms include burning or shooting pain around the genitals, sharp pains with sitting or standing, frequent urges to urinate despite no infection being present, and erectile dysfunction in males. These symptoms may lead to decreased quality of life as well as challenges with sexual intimacy for those affected by this condition.
What Are the Causes of Pudendal Neuralgia?
Pudendal neuralgia is an often debilitating condition caused by damage to the pudendal nerve, which innervates some organs in the pelvic area. This type of injury can occur due to trauma such as childbirth, accidents, or medical interventions, or due to degenerative processes such as increases in intra-abdominal pressure associated with pelvic floor weakness, prolonged seated periods, and constipation. In female patients, pudendal neuralgia may present with symptoms of vulvodynia, while male patients may experience symptoms that mimic prostatitis. Whatever the cause may be, dealing with pudendal neuralgia can considerably reduce a person’s quality of life since it can cause chronic and severe pain. Thankfully, physicians are now able to assess and diagnose this issue more accurately so that suitable treatment options can be offered early on.
How Is Pudendal Neuralgia Treated?
Pudendal neuralgia is a chronic pelvic pain disorder treated both conservatively and surgically. Initial management involves neuropathic medications, nerve blocks, and/or radiofrequency ablation to alleviate symptoms. For more challenging cases, neuromodulation with spinal cord stimulation or ketamine infusions may provide an answer to some of the most debilitating sources of pain for those living with pudendal neuralgia. A multidisciplinary team including urologists, neurologists, and anesthesiologists is often helpful in developing the best treatment approach for individual patients.
Neuropathic Pain Medications
Neuropathic pain medications can be particularly effective for treating pudendal neuralgia – these include anticonvulsants, tricyclics, and topical treatments such as lidocaine patches. Though each patient’s needs vary and certain treatments may work better than others in certain cases, the best option will typically be trialed until a solution is reached that provides enough comfort and alleviation of symptoms. With the right medications combined with other healthcare providers or lifestyle changes recommended by one’s doctor, pudendal neuralgia sufferers can hope to find adequate comfort and respite from their symptoms.
Nerve Blocks
Nerve blocks involve an injection of a mixture of anesthetics and steroids into the affected area near the nerves, acting as a barricade against pain signals that may reach the brain. This treatment is fast-acting and relatively straightforward and can be incredibly effective at providing relief from pudendal neuralgia pain. However, like all medical treatments, it should always be discussed with a specialist to ensure the most suitable option is chosen depending on each person’s circumstances.
Radiofrequency Ablation
Radiofrequency Ablation (RFA) has recently become a popular and effective treatment option for pudendal neuralgia. This relatively non-invasive and minimally painful procedure involves heating the nerve to decrease pain. After an injection of local anesthesia, a small needle is inserted and heated for about 60-90 seconds, potentially providing several months of pain relief. RFA treatments can provide relief from the recurrent tingling, burning, aching, and shooting pain associated with pudendal neuralgia without having to resort to other options like surgery or long-term medications. Patients often report a decreased need for heavy narcotic painkillers shortly after starting their course of RFA treatments.
Ketamine Infusions
Patients who suffer from pudendal neuralgia, a chronic pain disorder of the pelvic region, can experience substantial relief with ketamine infusions. This cutting-edge treatment has been rigorously studied and proven to provide promising results. Through ketamine’s unique mechanism of action, it helps to restore normal communication between the body and the brain thus blocking pain signals. Infusions are administered in a medical setting and monitored by an expert healthcare provider. In some cases, patients feel an immediate pain reduction, while in others the treatment may require more than one infusion for maximum effect. Whatever their experience may be, many report improved mobility, decreased anxiety, and improved quality of life after their treatments.
Spinal Cord Stimulation
Spinal cord stimulation is a minimally invasive and effective treatment option for pudendal neuralgia. This procedure works by delivering electrical signals to the troubled nerve fibers in the spine, which temporarily interrupts painful sensations. The efficacy of the treatment decreases pain intensity within minutes of stimulation, offering relief from chronic pelvic pain symptoms. Spinal cord stimulation is safe, with a low risk of complications; however, in some cases, patients may experience tingling in their extremities, as well as temporary changes in bladder or bowel function. Despite these potential side effects, spinal cord stimulation has been found to offer long-term relief to many of those diagnosed with pudendal neuralgia and should be considered an appropriate choice when considering treatment options.
Surgery
Surgery for pudendal neuralgia is a treatment option for those suffering from chronic pelvic pain in the area of the pudendal nerve. There are a variety of surgical techniques available to address this condition and they focus on relieving compression or irritation of the nerve caused by muscle or ligament tension or an anatomical variant such as entrapment of vessels along the course of the pudendal nerve. Surgery can be very successful at eliminating these pressure points, resulting in long-term pain relief if performed correctly and in combination with other physical therapy treatments. However, surgery also carries risks so it should only be considered after other forms of treatment have been attempted but proven ineffective.
Summary
Pudendal neuralgia is a condition that causes pain in the genitals and anal area. The pain is caused by damage or compression of the pudendal nerve. Treatment for pudendal neuralgia may include neuropathic pain medications, nerve blocks, radiofrequency ablation, ketamine infusions, spinal cord stimulation, and surgery. If you have any of the symptoms of pudendal neuralgia, make an appointment with your doctor to discuss treatment options.