Pudendal Nerve Entrapment: How Physical Therapy Can Help?

how physical therapy can help pudendal nerve entrapment

Men who have entrapped pudendal nerves (pudendal nerve entrapment) commonly complain about urinary problems such as urgency or frequency. It is also reported that men often experience erectile dysfunction despite using traditional erectile dysfunction treatment. While in other cases, they also describe it by having a feeling of a lump in their pelvis or groin area, even though there are none.

In light of the different symptoms they experience, how can we determine if the pudendal nerve is entrapped?

Let’s find out now.

Pudendal Nerve Entrapment

Pudendal neuralgia (also known as Alcock’s syndrome or Pudendal Canal Syndrome) is caused when the pudendal nerve is entrapped, compressed, or irritated, resulting in pain in the local region.  It is characterized by pain, swelling, and numbness in the pelvis or genital area. It occurs when a major nerve in the lower body is damaged or irritated, making it difficult to use the bathroom, have sex, or sit down. Experts believe this condition is rare, but it’s not clear how many people have it.

Symptoms of Pudendal Neuralgia

Pudendal neuralgia is characterized by pelvic pain as its primary symptom. When the pudendal nerve’s path is compressed by other structures, it irritates. Anywhere along the course of the nerve can produce pain, tingling, or other sensations, including the tip of the penis. The pain in this area is called pudendal neuralgia, which means “pudendal nerve pain.”

Also burning, stabbing, or shooting pain may occur, coupled with numbness or tingling sensations when you have pudendal nerve entrapment. Symptoms are commonly aggravated by activities involving bending at the hips, such as sitting and squatting.

Talk to your physician if you notice any new symptoms related to erectile dysfunction, urinary illness, or bowel problems. It’s possible that these symptoms are caused by a medical condition that needs to be addressed by your doctor. When a medical reason cannot be identified, there is a very good chance the nerve is being pressed by muscles or other tissues in the pelvic floor. Physiotherapy for pelvic floor disorders can be extremely helpful in these situations.

Causes of Pudendal Nerve Entrapment

The pudendal nerve can be damaged by several factors. An injury or surgery can cause it and sometimes, exercising too much, such as riding a bike, can contribute to it.

Other causes may include:

  • Pressure on the pudendal nerve caused by nearby muscles or tissue
  • Spending a lot of time sitting, cycling, horseback riding, or constipating (usually for many years) can sustain repeated minor pelvic injuries.
  • Pelvic surgery
  • A broken pelvis
  • Cancer or non-cancerous growth compressing the nerve

Some causes, however, cannot always be determined.

How to prevent pudendal neuralgia?

Pudendal neuralgia can be prevented through certain lifestyle changes. These includes:

  • Managing your bowels and bladder: Don’t strain when emptying your bowels or passing urine, as this stretches the nerve. Physiotherapy can help you establish good bladder and bowel habits that are suitable for you.
  • Sitting modification: Avoid pressure on the perineum (the area inside your ‘sit bones’), as this prevents pressure on the nerves. Sitting less can also reduce blood pressure.
  • Avoid nerve-irritating physical activities: riding a pushbike and horseback riding are two of the biggest. Other activities to avoid are trampoline jumping, bench pressing, and too many ‘core muscle’ exercises. With osteopathy and physiotherapy, you can identify movements unique to you that may need to be minimized.

Physiotherapy can help relieve Pudendal Neuralgia

Physiotherapists can help you relax and stretch your pelvic floor muscles, which may be over-contracted so that the nerve is less irritated. They can also help you to manage the painful trigger points in your pelvic floor muscles as well as recommending using TENS, if necessary, to relieve your pain. Using this device for self-management is effective – but you may need the assistance of a physiotherapist to place your electrodes properly.

Furthermore, you could benefit from specific external exercises and stretches that will focus on correcting your posture and avoiding activities that may aggravate your pain. Physiotherapists will also encourage you to do general cardio exercises to maintain both mental and physical fitness and strength.

Physical therapy can also help you maintain control over your bladder and bowels if you have pudendal neuralgia. They can help you develop a bowel and bladder management routine.

Your pelvic problems can best be treated by physical therapy. If you have the same symptoms for pudendal neuralgia, PELVIS.NYC can help assess your needs. We provide 15-minutes teleconsultation for FREE because we care for your health.