Sexy times might not be as sensational without the pudendal nerve. In fact, they downright wouldn’t be.
That’s the least of your worries though.
The pudendal nerve has control over a variety of pelvic muscles. This includes those that maintain our urine and fecal continence.
In summary each time you “hold it in,” you’ve got the pudendal nerve to thank for the ability.
This doesn’t just happen willy-nilly though. Lots of elements make up the multiple functions the pudendal nerve so dutifully performs.
Performing tasks as important as these, no wonder the pudendal nerve has an entire canal dedicated to its journey.
So what does it actually do? And why it seems so important? Keep reading to learn more about the pudendal nerve.
What Is The Pudendal Nerve?
The pudendal nerve innervates men and women’s external genitalia. This means that it has a pretty big job relaying signals from the urethra, genitals, and anal area.
As a motor, sensory, and autonomic nerve, its list of tasks come a long one. Before all that though, we give you some science to break it down.
The pudendal nerve can be found anywhere from nerve roots S2 – S4. These are among the sacral spinal nerves.
Autonomic functions, see the pudendal nerve carrying sympathetic fiber nerves to the dermatomal region found in routes S2 – S4.
When performing motor functions, the pudendal nerve supplies the external urethral sphincter. The same goes for the external anal sphincter, and multiple pelvic muscles with nerves to function.
This role is vitally important as this nerve literally controls our ability to go to the bathroom when we want to, as opposed to whenever.
Sensory functions of the pudendal nerve require it to supply nerves to the perineum, anal canal, the skin around the anus, and external genitalia of men and women.
As a paired nerve, it can be found on the left and right of the body. This makes for an interesting passage for both sides, as they each have specific functions to perform.
What Path Does The Pudendal Nerve Take?
With a route that’s more like an action movie than nerve path, the pudendal nerve makes sure it has a blast on its way to work.
As mentioned before, the network of nerve fibers found on the posterior wall is where its journey begins. This is known as the sacral plexus.
The S2, S3, and S4 spinal nerves are where formation begins. From there it gets a little complicated, but the breakdown will clear things up.
- Descends and passes between the ischioccygeus and piriformis muscles.
- Exits the pelvis through the lower level of the greater sciatic foramen.
- Makes a cross-over at the sacrospinous ligament. “A thin ligament attached to the ischial spine.” (1)
- Taps back to the pelvis via the lesser sciatic foramen.
- Joins forces with the pudendal vein and artery.
- Flows through Alcock’s canal (pudendal canal).
- While there it divides into branches. Initially the inferior rectal nerve, followed by the perineal, and finally the penis (in males) or clitoris’ (in females) dorsal nerve.
What’s kind of cool about all this is that each person’s nerve branches are unique and will vary from individual to individual? Generally, though, the left and right side of the body has the three branches mentioned above.
Like with any nerve or other body parts, there are different things that can cause damage.
Illnesses, trauma, and other external and internal influences affect our bodies in ways that can lead to the need for focused recovery.
It includes the following:
- Pudendal Nerve Entrapment
- Neuralgia (Pudendal)
- PN Irritation
- Perineal Pain
These are treatable but can put a toll on day-to-day living. Additionally, people often mistake these ailments for other root causes.
That’s why it’s always necessary to check with a medical professional, as opposed to relying on self-diagnosis.
What Is Pudendal Nerve Entrapment?
The pressure created along the pudendal nerve’s pathway make things as simple as sitting a pain in the butt. No pun intended.
Pudendal nerve entrapment (Alcock canal syndrome), is pretty much what it sounds like. The pudendal nerve becomes compressed or trapped, which causes chronic pain.
It is often confused with Pudendal Neuralgia (PN) and has been used interchangeably for years. A study published in 2009, saw the error in this. It stated, “Prevalence of PN is unknown and it seems to be a rare event.”
In essence, it is really another form of PN. Lower regions of the penis and scrotum, perineum, anus, pelvis, and vulva experience a kind of “phantom pain.”
Pudendal nerve irritation and perineal pain are levels of intensity as it relates to pain. But all mean one thing – discomfort, pain, and the possibility of more serious follow-up symptoms.
What Are The Symptoms of Pudendal Entrapment?
Various symptoms are associated with pudendal entrapment. They vary from minor to more noticeable signs.
It includes the following:
- Pain that worsens when wearing tight clothing.
- Numb genitals.
- Pubic pain.
- Posterior pelvic pain.
- Tightness and pain at the back of the hips.
- Men experience pain from the genitals and perineum.
- Women experience pain from the perineum, genitals, internally, and the pelvic floor.
- Sexual dysfunction.
- Chronic constipation.
- Rectal pain.
- Urinary incontinence.
- Fecal incontinence.
- Perineal or pelvic pain that increases when stressed out or sitting. It gets better when you sit on the toilet seat or are standing.
Before you run off thinking that every time you feel a pain or when you sit it has to do with the pudendal nerve. It happens not the case.
Many other ailments can cause pain or discomfort like this. For example, anal fissures, proximal hip abductor or hamstring injuries, and vulvodynia are among these.
Make sure your medical professional is familiar with the pudendal nerves and its treatment before you end up being treated for the wrong thing.
How Is Pudendal Entrapment Diagnosed?
There exist two tests doctors often use to diagnose pudendal entrapment.
A pudendal block test where the anesthetic is used to numb the nerve. If symptoms persist, it is not pudendal entrapment. However, if they don’t, then the nerve’s the culprit.
The other diagnosis method is known as the pudendal motor latency test. With this one, the nerve’s motor function comes measured. So, this allows doctors to determine if there has been nerve damage.
When major nerves in the lower body experience prolonged irritation or damage, this implies the pudendal neuralgia.
With much of the same symptoms as pudendal entrapment, it comes easily to see why they’re hard to distinguish.
Moreover, pain comes and goes and there are no figures as to how many people suffer from this ailment. However, physicians always consider the intensity of the two pudendal nerve damage problems.
The Damage Causes
- A prior injury or trauma.
- Musculoskeletal problems.
- Childbirth trauma.
- Colorectal surgery.
- Gynecological surgery.
- Overdoing a specific exercise (example cycling), especially if the nerve is already irritated.
- Bad posture.
- An untreated infection that can irritate the nerve.
- A tumor which can put pressure on the nerve.
Having already listed many common symptoms of pudendal entrapment, it’s not as necessary to share again here. However, there are others that make the top “to-watch” symptoms for pudendal neuralgia.
- Increased sensitivity in the lower body, genitals, anus, etc.
- Burning, sharp pain.
- Pain that extends to the legs, belly, and buttocks.
- The odd and frequent need to use the bathroom.
- Issues getting erections (for males).
Along with other methods of determining if a patient suffers from pudendal neuralgia, an MRI machine comes necessary. Certainly, this gives doctors a clear picture of what’s going on inside your body.
Hence, using radio waves and powerful magnets, MRI machines conduct imaging tests, giving doctors the visual data they need.
Treatment For Pudendal Neuralgia and Pudendal Entrapment
Notably, the availability of treatment options for pudendal entrapment and for the rare cases of pudendal neuralgia comes available.
With multiple options available as well, sufferers rest easy on a horizon fix.
Likewise, the best kind of treatment occurs on combination regimens. Many patients change lifestyle habits, use medicine, and engage in physical therapy to fix the damage.
For example, physical therapy stretches the lower pelvic muscles, eases pressure on the pudendal nerve. It also relaxes them for the same purpose.
Besides, this treatment aids with incontinence too. Moreover, it gives patients the peace of mind they need when carrying out daily tasks.
While exercise is fantastic, try to stay away from cycling, squats, or related exercises. Additionally, these make pudendal entrapment and PN worse.
Surprisingly, drugs that are used to treat conditions like epilepsy or depression, may also help with this. And, muscle relaxants are great to achieve symptom relief.
If none of these methods work, your doctor administers medications which lower information or numb the nerve. Further, both these things lessen pressure on the pudendal nerve.
However, this denotes not a quick fix, and patients often don’t experience full results for many weeks after they’ve begun treatment.
On rare occasions, surgery certainly implies a recommendation. Also, this removes anything that might be unnaturally pressing on the pudendal nerve.
Besides, to relieve pain, a small electrical device requires embedding under the skin. Thus, the pain signals sent to the brain denote interruption through nerve stimulation.
For minor cases, and to help those with more intense symptoms, patients should stand more often or sit up straight. Ultimately, doing these things lessen the pressure on the nerve.
Conclusively, the pudendal nerve has its part to play in the effective running of your body’s functions. Discounting its vital role leads us to a life lot messier and painful.