Pudendal nerve entrapment occurs when the nerve is compressed, such as from a tumor. Symptoms include painful bowel movements and groin pain. Some treatments and exercises can help you manage the pain.
Pudendal nerve entrapment happens when the pudendal nerve, which carries signals from your genital and anal area to your spinal cord, becomes compressed and causes chronic pelvic pain.
Read on to learn about the possible causes of pudendal nerve entrapment, how to recognize its symptoms, and what treatments are available for this type of nerve pain.
Possible causes of pudendal nerve compression include:
- Putting too much pressure on your pelvis: Activities like riding a bike or not pooping regularly can overwork pelvic muscles and cause inflammation that compresses the pudendal nerve.
- Sitting for a long time: Activities that involve extended periods of sitting, such as working in an office job, are common causes of nerve compression in the lower spine and pelvic area.
- Muscle strains or tightness: Strained muscles or ligaments near the pudendal nerve can put pressure on the nerve and cause pain.
- Damage from surgery: There’s a dense network of nerves in your pelvic area. Surgeries like prostatectomy can cause damage or irritation to these nerves.
- Broken or fractured bones: Broken bones in your pelvis can irritate the pudendal nerve.
- Giving birth: Strain and pressure from childbirth can cause compression or damage to the pudendal nerve.
- Growths, tumors, or cancerous tissue: Growths or tumors in your pelvic area, especially those associated with prostate cancer, can put pressure on the pudendal nerve.
Shooting, stabbing, or burning pain is the most noticeable symptom of pudendal nerve entrapment.
Branches of the nerve that travel to several major parts of your pelvic area can cause pain in your:
- vagina, labia, or clitoris (clitoral branch)
- penis or scrotum (penile branch)
- perineum (perineal branch)
- anus or rectum (rectal branch)
Other symptoms can include:
- pain or sensitivity that feels worse when you put on underwear or tight clothes on your pelvic area
- a feeling of swelling or fullness near your anus like something is stuck
- feeling like you need to pee even if nothing comes out
- pain or discomfort when you poop
- pain when you have sex (dyspareunia)
- having trouble having an orgasm when you have sex or masturbate
- trouble getting or keeping an erection (erectile dysfunction)
- loss of feeling in your feet and legs
When to contact a doctor
Contact a doctor if you note any of the following symptoms:
- a persistent feeling of tingling or numbness in your pelvic or genital area
- feeling like something’s stuck in your anus no matter how often you poop
- feeling like you need to pee a lot even if very little comes out
- pain, burning, or stinging when you pee
- experiencing any pain or numbness when you have sex
A doctor will likely ask you about your lifestyle and medical history. They’ll also do a physical examination to look for any other causes of pudendal nerve pain causes.
A doctor may recommend tests, depending on the pattern of pain and other symptoms you’re having. Potential tests include:
- Digital exam: They’ll insert a finger into your vagina or rectum to feel for causes of pressure.
- Magnetic resource imaging (MRI): An MRI can help them look at the pelvic area for a tumor that may be the underlying cause.
- Electromyography (EMG): An EMG can show how the nerve responds to electrical signals.
- Nerve blockers: They can inject nerve blockers into the pudendal nerve to see whether numbing the nerve helps reduce your pain.
Treatment for pudendal nerve entrapment depends on how serious the pain is and what’s compressing or damaging the nerve.
You may need to avoid or limit activities that cause nerve compression to help prevent, reduce, or eliminate pudendal nerve pain. A doctor might suggest that you:
- Ride bicycles or motorcycles less frequently.
- Rest between long periods of walking, running, or sitting.
- Stand up and move around frequently when you have to sit for long periods.
- Use a standing desk or take a 5- to 10-minute break every hour to stand up.
- Use a seat cushion on the places you sit.
- Reduce how much you strain when you poop by eating more fiber or drinking enough water.
Corticosteroid or local anesthetic injections can help temporarily relieve pain. Anesthetic injections do this by blocking nerve signals. Corticosteroid injections reduce swelling and inflammation.
A healthcare professional will usually administer these injections every few months. But these medications aren’t recommended for long-term use.
Other prescribed medications to help control pain may include:
- anticonvulsants like carbamazepine
- nerve stabilizers like gabapentin
- tricyclic antidepressants like amoxapine
In severe cases, a doctor may recommend decompression surgery. This procedure can remove the cause of compression, such as a tumor or damaged tissue, and relieve the pressure on the pudendal nerve.
While you should avoid some exercises, such as hip flexion exercises and jogging, some exercises can be beneficial. Exercising or stretching your pelvic muscles regularly can help prevent strain or inflammation by strengthening your muscles and improving flexibility.
Your doctor may recommend physical therapy for
- Lie flat and bend your knees with your feet on the ground.
- Breathe out, then breathe in slowly while rapidly flexing and releasing your pelvic floor muscles. Flex your muscles for about one second each time.
- Repeat for about 10 flexes. Do this two to three times per day.
- Lie flat and bend your knees.
- Inhale through your nose and exhale through your mouth.
- Lift your pelvis and flex your core muscles.
- Slide the heel of your right foot away from your body.
- Slowly inhale while sliding your foot back to your body.
- Repeat 10 times for each leg at least once per day.
- Lie flat or sit on the ground.
- Spend a few moments relaxing and reducing tension throughout your body.
- Place one hand on your chest and the other on your stomach.
- Breathe in slowly through your nose for a few seconds so that your stomach expands but not your chest.
- Breathe out slowly through your nose.
- Repeat a few more times with your hands staying on your chest and stomach.
Pudendal nerve entrapment is often treatable and doesn’t cause any long-term complications or changes to your quality of life.
And about 60% to 80% of people with severe pudendal nerve entrapment who get surgery also experience significant, long lasting relief.
Pudendal nerve entrapment happens when your pudendal nerve is compressed and causes pain.
This type of nerve compression isn’t hard to treat. Reducing this kind of pain can help you continue your daily activities with minimal disruption and improve your quality of life.