Vaginal and tailbone pain: is it pudendal neuralgia?
Pudendal neuralgia (or Alcock's canal syndrome) is a pathology that causes very sharp and disabling pain in the genital area and lower abdomen. It mainly affects women and people with vaginas and has many negative consequences on daily life and sexual life in particular.
What is pudendal neuralgia?
A painful and disabling disease
Pudendal neuralgia is caused by an injury or inflammation of the pudendal nerve located in the perineum. It is estimated that approximately 0.6% of the population is affected by this disorder, both men and women. Among those suffering from this problem, 3% are in an acute painful phase. This disease causes intense and often disabling pain that is particularly noticeable when sitting. Its impact on daily life is very significant and strongly impacts the quality of life on a social, professional and of course sexual level.
A rare and difficult to diagnose disorder
Pudendal neuralgia is unfortunately little known among health professionals. Its teaching in medical schools is relatively recent. This obviously complicates its diagnosis and sometimes leads to unnecessary medical or even surgical procedures that only increase the stress and discomfort of the person suffering from it.
Symptoms of neuralgic attacks
Pudendal neuralgia attacks can last for several years. They mainly affect women and people with vaginas, but men can also suffer from them. The pain is particularly noticeable in the anus, coccyx, sacrum, lower back, pubis and genitals (penis, vagina, clitoris). It is felt intensely in the form of burning when sitting and is relieved by lying down.
Painful sensations may be accompanied by a feeling of having a foreign body in the rectum or vagina and false urges to urinate or defecate. In some people, there may also be spontaneous and unwanted and therefore unbearable ejaculations or orgasms.
The causes of this condition
Pudendal nerve damage can be the result of a direct injury during a serious fall on the buttocks, during a seated sport (cycling, horse riding), during childbirth or following a gynecological (episiotomy) or urological procedure. However, in most cases, inflammation of the nerve is caused by repeated muscle contractions in the perineum. Stress is often the main cause of these. This is why people aged 50 to 70 are most affected by this condition.
Pudendal neuralgia affects women and can impact intimate comfort
The pudendal nerve is responsible for the innervation of the pelvic area. This is particularly stressed in the female population, especially at the time of childbirth, which explains why women and people with vaginas suffer more often from pudendal neuralgia. When it appears in the postpartum period (after childbirth), it can leave serious psychological after-effects, this phase of life rhyming with greater psychological vulnerability.
In women and people with vaginas, it is characterized by very intense pain in the clitoris, vagina and anus. It can also cause unwanted orgasms, fecal incontinence, dyspareunia and burning sensations that make any intimate intercourse by penetration practically impossible. In addition, the stress caused by this disease can seriously affect the libido.
What solutions exist to treat this disease?
Most painkillers are not very effective
Most conventional painkillers are not effective on the symptoms caused by inflammation of the pudendal nerve. Only certain antiepileptics can help alleviate these. Since this disorder is most often caused by the contraction of the muscles surrounding the nerve, the use of drugs acting on this particular point is a good solution.
Traditional muscle relaxants are not indicated, because their action is too limited in time. To induce good relaxation of the pelvic muscles, the prescription of an antidepressant for about 6 months can be effective. In addition, all relaxing therapies can give a boost, such as hypnosis, sophrology, etc.
Surgery in severe cases
In some cases, surgery may be necessary. This involves removing the adhesions that have formed around the irritated nerve and compress it, causing the painful sensations. It will then take between 1 and 2 years for the nerve to regenerate. This operation, although simple, is unfortunately rarely performed due to the lack of surgeons who know the pelvic area well enough to achieve the expected success. In addition, some people continue to suffer even after having had it.
Exercises to relieve the pudendal nerve
There are exercises to relieve the pudendal nerve that help alleviate pain:
- Spinal manipulation and mobilization techniques to help release the nerve
- Exercises that help the nerve slide through its sheath
- Exercises that particularly stimulate the muscles of the lower abdomen, perineum and upper thighs
- Methods acting on the perineal muscles
- Kinesiology exercises involving breathing, relaxation and adopting good postures
- To perform this type of exercise that relieves the pudendal nerve, it is best to seek the services of a physiotherapist, kinesiologist or osteopath.
Suffering from pain is never normal!
Although it is sometimes difficult to discuss this type of subject, it is essential to talk about the pain that affects the perineum as it can have a negative impact on daily life. In the absence of a satisfactory answer, do not hesitate to seek several medical opinions or join support groups in order to be able to exchange. Only the freedom of speech can make this condition known and facilitate its diagnosis and treatment.
