Health Organization for Pudendal Education

For many years I have been suffering from pain while sitting, urination difficulty, reduced sexual sensation and sometimes painful ejaculation. My external urethral sphincter is always spasmed.

I have recently tried these exercises:
https://youtu.be/2yx0_PK0Q-4?si=RUPCmmYzWeObSwSI&t=125

They made my sitting pain considerably worse. The increased pain persisted for days and only taking a long walk brings the pain back to the level I had before the exercises.
Does this mean my problem is in the muscles and not the nerve? I haven't tried muscle relaxants because they can cause urination difficulty. Or should I now try kegel exercises?
I live in a third world country and I can't travel to where I can find pelvic floor specialists.

Hi Zizo,

I'm sorry your exercises have made your pain worse. I did not click on that link, but some pelvic exercises (especially kegels) can make pn worse, especially if the nerve is entrapped. Just to be cautious, I also avoid some kinds of regular exercise, especially if it involves stepping or hiking, because my pn started with intense workouts on a step machine. But if you are spasming, I can understand your interest in trying to relax the muscles. Since you cannot see a pelvic pt, you might be able to massage the muscles and ligaments on the outside to calm it down. That seems like the kind of thing pts do.

I don't think that the increased pain means that your problem is due to the muscles and not the nerve. In fact, I think the fact that pelvic movement increased your pain suggests the source of the pain is the nerve. And it might mean that it is entrapped in a ligament.

I hope that helps a little bit. Violet might have more ideas.

Take care,
April

Hi Zizo,

I don't know about those specific exercises but I agree with Amy that exercise, including kegals, can make things worse, especially if you have an irritated pudendal nerve. Exercise is one of things that triggered pudendal neuralgia for me. I don't know if you have access to purchase things on Amazon but there is a book that might be helpful to you. One of our members reminded me of it recently. It is titled "Breaking Through Chronic Pelvic Pain" by Jerome Weiss. It could give you some ideas for self-treatment. You could also try warm heat packs if you can get them.

If you must exercise, swimming (except for the frog kick) is one exercise that is typically more friendly to people with pudendal neuralgia.

Violet