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Pudendal Nerve Problems

The pudendal nerve has three branches that run through the pelvic region of both men and women. When this nerve becomes inflamed or trapped, pain occurs in the buttock, hip, rectal and genital area. This condition may be called pudendal nerve entrapment or pudendal nerve syndrome.

  1. Causes

    • Causes of pudendal nerve problems include sports injuries such as weight lifting or cycling, tumors compressing the nerve, prolonged sitting and childbirth.

    Symptoms

    • Symptoms of pudendal nerve problems include pain when sitting; pain that increases as the day progresses and is worse at night; and pain that is relieved somewhat by laying down. It is typically a burning pain that may include stabbing, electric shock-like sensations and numbness.

    Pudendal Nerve Entrapment

    • Pudendal nerve entrapment symptoms may include inflammation of the nerve pathway when walking or running for long periods. Pain during bowel movements and bladder leakage are also common. Women may feel pain during intercourse and men may experience pain in the testicular region and during ejaculation.

    Diagnosis

    • Pudendal nerve damage is diagnosed through MRI and CT scans, which reveal compression of the nerve by tumors or injury.

    Treatment

    • Treatment for pudendal nerve problems will include over-the-counter medications such as ibuprofen to fight inflammation and pain. Tricylic antidepressants such as amptriptyline work to block pain signals from the brain. Injections of corticosteroid may reduce pain and inflammation faster than using medications. Heat may reduce pain and stiffness in the affected area and cold packs applied three times a day for 15 minutes reduce inflammation and swelling. Avoid sitting for prolonged periods by taking breaks more often. Bicycling is the most common sport for injury to the pudendal nerve. Make sure your bike seat is comfortable and take several breaks when riding.

    Surgery

    • Surgery for the pudendal nerve may be recommended if damage is limited and decompression of the nerve results in decreasing pain. Pain may not be relieved by surgery if the nerve has extensive damage. Your doctor will be able to advise you on the correct treatment path for pudendal nerve problems.

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