These also need to be assessed in complex pelvic pain presentations Other nerves that supply to the groin/ scrotum and genitals include genito-femoral nerve and obturator nerve. The joints of the pelvis are also supported by some of the strongest ligaments in the body The pelvis is often considered to be the hub of the human skeleton because it connects between the spine and the legs, and has 35 muscles attaching onto it. Firstly, the pelvis is made up of 3 bones: the 2 innominates and the sacrum, with the coccyx being attached to the inferior pole of the sacrum. The key to understanding pudendal nerve irritation is to understand the anatomy of the posterior pelvis and how this part of the body is involved in our movements, stability, and daily life. Physiotherapy has proven to be a very successful treatment option for pudendal neuralgia, pudendal nerve irritation and pudendal nerve entrapment. This muscle over activity is thought to create narrowing of the pathway through which the nerve passes between sacrospinous and sacrotuberous ligaments (Alcocks canal), and/or between an interface created by ischiococcygeus, piriformis and obturator internus muscles.įigure 1: Pathway of the Pudendal nerve from the sacral plexus through Alcocks canal toward the genitals Pudendal nerve irritation, sometimes called pudendal neuralgia, may create changes in sensation in any or all areas the nerve supplies, and will tend to be associated with over-activity, or spasm of posterior pelvic floor muscles.
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pelvic/perineal pain that is worse with sitting or when stressed, but that improves with standing or sitting on the toilet seat posterior pelvic pain or pubic/ groin pain pain and tightness into the back of the hips pain into the genitals and perineum and around the back passage in men pain referring into the perineum, pelvic floor, groin, genitals (scrotum and penis in men/ labial & vagina pain, vaginismus and internally in women) Pudendal nerve irritation, pudendal nerve entrapment, and perineal pain are all varying levels of symptoms related to pressure being created along the pathway of the pudendal nerve that creates very uncomfortable symptoms including: Treatment of Pudendal Nerve Irritation, Groin and Perineal Pain