Irritated nerves

Nerve pain, neuropathic pain, neuralgia, nerve entrapment: to operate or not to operate
When it comes to chronic pelvic pain, the thing most often described on the Internet is entrapment of the Pudendal nerve (nervus Pudendus). There are many articles about surgical techniques that can free an entrapped nerve. But such nerve entrapment is relatively rare. More often it is an irritation of the nerve. In many cases, this irritation is the result of adhesions of connective tissue and scars, tense muscles pressing on the nerve, or asymmetry in the pelvis or back that causes the ligaments over which the nerve runs to be tight. These are all causes that can be treated without surgery.

About the Pudendus nerve
The Pudendal nerve is an important nerve in the pelvic area. For example, this nerve allows us to tighten the pelvic floor muscles so that we can control urination and defecation. The nerve also provides sensation in the anus and rectum, in the clitoris, vagina and labia, in the tip of the penis and the posterior part of the scrotum.

An overstimulated, irritated or pinched Pudendal nerve in the pelvis causes:
– Pain with sitting (when standing or lying down, the pain may disappear completely, but it does not have to).
– The character of the  pain is sharp, shooting, electric or burning.
– The pain can be felt in the vagina, or in the labia, the clitoris, at the sit bones, in the  perineum, the skin between vagina and anus, or in men scrotum and in the anus.
– You may also experience tingling or a numb sensation, rather than pain.
– The skin reacts more or less sensitive to touch.
– You may feel like you have a prolapse, when no prolapse has been diagnosed.
– Evacuation of stool may make the pain worse.
– Ejaculation may be more difficult or more sensitive.
– Often the pain is on one side of the body, but it can occur on both sides.

Possible causes of an overstimulated, pinched or irritated nerve in the pelvic floor include:
– Childbirth.
– Surgery in the lower body.
– Prolonged cycling.
– Low back pain.
– Pelvic pain.
– An accident, such as a fall from a bicycle or stairs.

– The muscles in the abdomen, pelvis or pelvic floor are too tense.

– Chronic constipation.
– Varicose veins.
– Lots of coughing.

In addition to the Pudendal nerve, there are many other nerves that can cause complaints in the pelvis and lower abdomen. One complaint we also hear from many patients is groin pain. This may also be caused by irritated nerves: the Genitofemoralis nerve or the Ilioinguinalis nerve. But there are more neves that can be compromised. The Obturator nerve, the Cluneal nerves, the Ischal nerve, the femoral nerve or the posterior femoral cutaneous nerve. The knowledge of the pelvic nerves as a cause of chronic pelvic pain is no common knowledge. If you think you might be suffering from nerve pain in the pelvic area ask your healthcare provider if they are familiar with how to diagnose and treat these problems.