Health Organization for Pudendal Education

Hi,

I am still confused about the difference between pudendal neuralgia and pudendal nerve entrapment and how can a doctor tell which one you have?

Am I right in understanding that an entrapment will not respond to conservative measures at all and surgery is the only option?

Kath

This video is great for explaining it. Watch from about from about 4.28

http://www.youtube.com/watch?v=juAve2pN ... er&list=UL

Honestly, I don't think even the doctors can determine this unless you have surgery. Some of us have had MRI's, which according to Dr. Potter show entrapments; but all of the doctors I have been to say that the MRI CANNOT show entrapment. It can show areas of thickening or scar tissue, which may or may not be entrapping the nerves or this could even be found in normal people. Unfortunately, no double blind studies have been done to document this.

Here's my theory as a non-medical person:

Simple irritation Example: Bicylists goes out for a 6 hour bike ride. After the bike ride, his butt and perineum feel numb. Next day, he's fine. He probably had PN irritation due to compressing the nerve on the bike seat too long.

Neuralgia - an individual has a predisposing factor - ie - loose ligaments, uneven gait, uneven pelvis, anterior rotation, upslips, downslips, etc. which cause some pathology in relation to the PN nerve (ie., ligament rubbing against nerve, obturatus internus muscle spasms rubbing on nerve). If nerve is not damaged, but irritated, once offending pathology is gone - so is PN. Another example, which doesn't happen very often either, is if the nerve has not suffered irritation long enough and a steroid injection is able to reduce inflammation in the nerve - so it doesn't continue to be irritated and subject to later entrapment.

Entrapment - nerve is actually flattened and/or entrapped by pathology - whether it be scar tissue, ligaments, etc. No amount of injections, PT, etc will fix it. Only surgery. Although I do wonder if shockwave might be a plausible option if it is scar tissue.

Neuralgia is saying, pain from a nerve. Entrapment is saying, a way to cause nerve pain. Neuralgia is a sort of general thing thing to say. Entrapment is a more specific thing to say. There are several ways to try to take away neuralgia. There is only one way to take away entrapment. You can still have neuralgia (emporarily,or permanently, at a variable degree) after removal of entrapment. There just isn't any solid way to predict it.