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Pudendal Nerve
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Pudendal Nerve

Has anyone heard of the pudendal nerve?  My physical therapist seems to think that is my problem since steroids, physical therapy, gel cushions, etc. has not worked.  I looked it up uner tipna.org and there's a good bit of information on this.  When it all comes down (if surgery is not an option) I just can't sit the rest of my life.  Any suggestions???
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Avatar_m_tn
Hi there,
I am sorry I did not really get your question quite right. What problems are you exactly facing? You have not describe what problems you are facing.
Chronic pelvic pain syndrome is a conundrum that may be explained partly by pudendal nerve entrapment (PNE), which causes neuropathic pain. In men with PNE, aberrant development and subsequent malpositioning of the ischial spine appear to be associated with athletic activities during their youth. The changes occur during the period of development and ossification of the spinous process of the ischium.
In order to help you I need to know what exactly are you facing. If you have any further queries do get in touch with me.
Regards,
Dr Sylvester, MD
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Avatar_f_tn
Thanks for your response.  I have pain in my right buttock or ischial tuberosity area.  It only hurts when I sit.  I can walk, stand, do exercises and it does not hurt.  I sit at a computer at work and try to stand as often as I can.  When I watch TV or read at home I sit on an ice pack or heating pad.  I use pain patches and a  7.5mg lorbtab when needed.  I am 74 years old and dread the day I cannot work and will have to sit more and have this chronic pain.  I understand there is surgery for the pudental nerve but not for people my age.  I was wondering if I should see a neurologist.  I have been to orthopedics and pain management doctors but nothing they have done seems to have helped.
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Avatar_m_tn
Hi there,
Nice to hear from you. Since you have already visited orthopedics and pain management with little help I assume that necessary diagnostic imaging studies have already been done. It would help if you could give me the details of such an imaging study. Since I do not have the privilege to examine you I can probably advise you on how to allay the pain rather than come to a diagnosis. Since you do mention that most of your pain is while sitting not otherwise I hope that you are following the necessary precautions to avoid getting an awkward posture while sitting.
Sitting with an unsupported back puts a great deal of pressure on the spine. (This situation includes sitting on the floor for exercise or meditation purposes.) To avoid low back pain while sitting, select a chair with a back that is both sturdy and somewhat flexible—if not padded. If the small of your back does not feel right when you are sitting, the chair may not have enough lumbar support for you. A small pillow or a rolled-up towel can help. Experiment until you find the location for the pillow or towel that feels the best; the pressure inside your spine is lowest when you feel the most comfortable. Keep your knees slightly higher than your hips. If you cannot change the height of the seat, rest your feet on books or on a low footstool. Your feet should be flat on the floor; legs crossed at the knees places uneven pressure on the spine.
See a chiropractor for this. Chiropractic treatment is an evidence based medicine and is known to reduce chronic back problems.
If you have any further queries do get in touch with me.
Regards,
Dr Sylvester, MD
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623131_tn?1223061075
I found that I have PNE after going to Houston and ti see Dr. Ken Renney.I had a nerve conduction test that showed abnormal nerve bla bla...Anyway that led to 2 nerve blocks, they lasted one and a half months to two plus months.When you call dr. renneys office they will set up a phone conversation that will lead to a e-mail with dr.R. and the two of you will decide if it is worth the trip. Ultimatley you will decide.Anyway I will probably do the surgery,just because of my personal situation.Most docs. will no nothing about this pne stuff.I cant work so I reserched a ton for years. My pain started in Oct. 02 ,as well like everybody else the doc,s thought it was in the head after no test showed any problems (mri,s catscans, a month at mayo in MN. etc.) pain mgnt.masked the pain but no answers TILL,I happen to be on this forum and a nurse thought it sounded like I might have PNE.I never heard of such.Now I know more than any doc.in my town.I dont have an ego,its just when these neurolist went to school I guess they had very little knowlege of the subject.They need to teach them in continue education,because their are alot of desperate people in lots of pain.Dr. Ansel who preforms the surgery in TX has a 66% success rate.I personally would do the TX. gamet of jumping through the hoops to get the info instead of Mayo clinic.One year ago if i were to look up PNE on mayos site / NOTHING.Dr. Renney in TX. had pne and studied in europe under the only Dr. who did the surgery at the time.So Renney,Ansil and popiney went to learn.Mayo says go in one way,the guys in Houston go in another.I would read all about it/know it/study it, and of course PRAY! If the nerve blocks help and  the nerve conducation shows abnormality (by the way the second most painful thing iv ever had) and you have the history of signs of PNE then you more than likely found your chronic problem.If it,s not it dont get discouraged,fourms like this have alot of people who want to help,people in every feild.I as well have peripheral neuropathy at 33 years old and I can say peace is possible.My strength is spent so I half to rely on Gods grace to give me everything.God bless you! pray pray pray
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623131_tn?1223061075
I forgot to mention that Dr. Ansel (or ansell) has preformed over 350 of these surgery's.Nothing against other neuro surgeons, I personally will go with the most experienced in this area.I can give you some #'s  if you care to go with these guys.
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Avatar_m_tn
Dr. Ansel In TX Surgery 2008 - Right Side Decompression PNE
If there is anything you need to know it is that there is a light at the end of the tunnel. It is faint at times but by giving yourself a better place in life to view it from is a necessity. Don't wait to start designing your own comfort zone. Arrange things in life the way you want them. Friends and Family are worth more than any stupid electronics or fancy clothes. Just go on being you in a very idle mode.. Number one get a laptop and take life easy that will help you land the super jet you are in control of..NERVES!  ; / find the good in life...

ps-DO NOT SIT, I REPEAT, DO NOT SIT!

12 years in pain and no hope of recovery. Every 3 weeks nerve shots... water therapy is the key.. and i mean everyday.. just a little to push out the pain toxins..
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Avatar_m_tn
PNE 13, what do u mean by water therapy?
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Avatar_m_tn
Water therapy? well I use it in a loose context....
What I really mean is get into the pool as often as you can... I had a mild stroke a few months ago because I was working full time. Don't push yourself if you have PNE.. You will end up in a deeper pit... Get to the pool and float around... In my condition I can't really swim because the pain is so severe...But using your arms keeps you from getting neural plasticity which is when your spinal cord changes from giving parts of your body feelings and sends it pain toxins instead. So even though doing something as simple as moving your arms in pool isn't helping the actual pain it is preventing you from getting a disease in your spinal cord that can take very long to recover from..
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Avatar_n_tn
I recently saw a specialist as i have been experiencing bladder issues. The specialist says it appears to be affecting a branch of
the pudendal nerve that supplies the vagina. Does anyone know anything that can help? im on medication. has anyone had pulsed radiofrequency to the pudendal nerve. Did it help? Does anyone know of any exercises that may help etc?
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Avatar_dr_m_tn
Hello!

Pudendal nerve entrapment (PNE) is an uncommon source of chronic pain, in which the pudendal nerve (located in the pelvis) is entrapped or compressed.

The pudendal nerve is a sensory, autonomic, and motor nerve that carries signals to and from the genitals, anal area, and urethra.

Possible symptoms include burning, loss of sensation or numbness, increased sensitivity, electric shock or stabbing pain, knife like or aching pain, feeling of a lump or foreign body, twisting or pinching, abnormal temperature sensations, constipation, pain and straining with bowel movements, straining or burning when urinating, painful intercourse, and sexual dysfunction which include hyperarousal or decreased sensitivity.

Treatment include include pelvic floor physical therapy to relax the overly tense pelvic floor muscles, medications, pudendal nerve blocks, and if an entrapment is suspected pudendal nerve decompression surgery.

Take care!
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Avatar_f_tn
Is sitting (although painful) with PNE damaging (I have been out of work as a paralegal for 8 weeks and would like to return.) I also am recovering from shingles in THAT area-I am an otherwise healthy 71 year old female). Thank you very much. P.S. I have a donut cushion-helps some.
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