Pudendal Nerve Entrapment

[nick9c]

Hi, I've posted a couple of times and want to make some observations. After having been diagnosed with non-bacterial prostatitis last November and subjected to 5 different antibiotics, I am now fully off the drugs. I saw a 2nd urologist last week who now contends that I likely have IC, but I'm confident that I'm not having any bladder pain.

At the same time last week, I thought that I would try something different and avoid sitting at work because I noticed that I tended to feel fine the majority of the time when I wake up in the morning (laying). Surprisingly since I have avoided sitting at work and have rigged up my computer for me to stand, I have had little or no urinary urge/pain during the day that I used to have. I also notice that within about 30 minutes after I sit down in the car or at home, the pain and urinary urgence returns and I feel the flare up starting. Yet when I lay down or stand up, it whithers away.

This simple observation leads me to believe that the act of sitting is causing pressure or entrapping the pudendal nerve on my left side (where the pain mostly lies). I'd be interested in knowing how many other people on here may be experiencing the same type of problem. I have discussed with my specialists that this may be a neuromuscular problem from the start, as the whole condition started after doing heavy lifting in my yard the day before all the symptoms began. I think for many who have not found answers, pudendal nerve entrapment needs to be looked at more seriously. This is a relatively new syndrome that most doctors seem to know nothing about.

Nick

[scoobysnacks]

Yes, but it may be that you caught it in time and you dont have entrapment, but rather inflammation from a muscular problem. Id think if it were entrapped fully merely standing would do little to help the problem. Do some more research, there is a board very similar to this one on pudendal nerver entrapment.

SS

[Paso]

I would really go for relaxation and PT work. That could very well help you.

/Paso

[alprost]

I would really go for relaxation and PT work. That could very well help you.

/Paso

I'd agree 100%. If you have pelvic floor muscle spasm (particulary if your obturator internus is involved), this could compress your pudendal nerve, and the increased pressure from sitting could exaccerbate this further.

The bottom line is that you need to be evaluated and treated (if required) for pelvic floor spasm. If you still have symptoms after this, then you should look into other factors such as PNE.

[prostateman]

I would really go for relaxation and PT work. That could very well help you.

/Paso

Be careful about doing physical exercises (like piriformis stretches) IF you turn out to have pudendal nerve entrapment and not just a muscular problem. This could cause aggravation or damage to your pudendal nerve. If I were you I would first see a doctor who is able to rule in or out pudendal nerve entrapment/neuropathy as a cause before you do exercises that might harm you.

BTW, judging from what you are describing your symptoms COULD very well be related to the pudendal nerve.

Prostateman

[rr]

My symptoms and solution are exactly the same. Unfortunately, I have been unable to build a lecturn in my office. Note to all, whom can I see about nerve entrapment, the first neurologist I saw snickered when I mentioned nerve entrapment and followed by asking me if I was single. I first noticed the relationship between not sitting and reduction of pain over the holidays. By the fourth day into my vacation, the pain was gone and stayed until my third day back to work. Anectodal, yes, but worthy of mentioning. Addendum, I don't believe it was stress related, like most, I was _glad_ the holidays ended.

[prostateman]

See these links for some experts on the pudendal nerve: http://pudendal.info/info/doctors/index.htm and http://pudendal.de/

[alprost]

Be careful about doing physical exercises (like piriformis stretches) IF you turn out to have pudendal nerve entrapment and not just a muscular problem. This could cause aggravation or damage to your pudendal nerve.

I agree that you should avoid exercises such as the one you describe if PNE is suspected. However, a manual pelvic floor exam and EMG assessment would be perfectly safe and, given that research shows that this is the key problem in the majority of cases, it should certainly be one of the first diagnostic procedures carried out.

BTW, judging from what you are describing your symptoms COULD very well be related to the pudendal nerve.
Prostateman

Yes, but they are all common symptoms associated with CPPS/pelvic floor muscle spasm also. I suppose the key question is this: Is the pudendal nerve compressed due to the presence of pelvic floor/obturator internus muscle spasm, or is it entrapped due to some anatomical factor, such as an unusually shaped ischial spine?

My own opinion is that pelvic floor muscle spasm is the cheif suspect in the majority of cases, but that when people still exhibit these symptoms after having pelvic floor muscle spasm either treated or ruled out, then PNE should certainly be fully investigated.