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What Causes Pudendal Nerve Entrapment?

Posted on Tue, 23 May 2017

Question: My question is treatment of what has been diagnosed as pudental nerve entrapment. For the past 7 years it has been painful to sit. I have had injections, P T., acupressure without any noticeable change. I do not want to have surgery. I manage when it is mild but can't when there are flare-ups. It is a burning sensation. Any suggestions? My email is YYYY@YYYY

Answered by Dr. T Chandrakant (31 minutes later)

Brief Answer:
Medicines available for Neuralgic pain.

Detailed Answer:
Hi.
Thanks for your query, albeit short and specific.
To recapitulate: Female/75 - diagnosed as Pudendal Nerve Entrapment - that is PNE - 7 years - can not manage when there are flare-ups - burning - tries injections, PT and acupressure without any noticeable change ...
Since you have not mentioned, please tell me whether medicines like Amitriptyline, Gabapentin or Pregabalin or Carbamazepine tried till now?
What are the exact symptoms - please give details.
What were the supportive clinical examination and investigations done to say this to be PNE?

Awaiting for your feedback.
With Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (55 minutes later)

The diagnosis of PNE was given by Mayo Clinic. I was given the prescription of Gabapentin which caused me to be dizzy. I do not do well with prescription drugs- have side effects. Had the injections recommended by Mayo at a pain clinic in XXXXXXX The symptoms are a strong burning sensation in the buttocks where I sit, some in groin and hip area as well.The feeling is there somewhat all the time and gets more painful with sitting. Also hard to find a comfortable position for sleeping. I am not comfortable sleeping on my stomach. Now, during a month long flare-up I am feeling very discouraged.

Answered by Dr. T Chandrakant (11 hours later)

Brief Answer:
Proper dosages and medication.

Detailed Answer:
PNE itself id a rare disorder and diagnosis and hence the studies are limited and treatment controversial in a sense that not a single definite treatment works.
Hence the need of trial and error methods.
If Gabapentin is causing you dizziness the initial dosage needs to be reduced till the body gets adjusted to the minimal dosages and gradually increased to be tolerated yet to be effective. What was the dose were you taking?

Other medicines as mentioned above can be tried and the best suitable and effective one continued so that you can become symptom-free as well as there will be no or most minimum flareups.
Please discuss this with your Doctor/s and get started with the medical management if you do not want surgery.
Use doughnut pillow wherever and whenever possible as this also helps to bypass the pressure.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (2 days later)

Dear Dr. Chandrakant, Thank you for your response which I will take into consideration. At this time I would like to discontinue any financial long term membership with the online plan. Thanks again for your help. XXXXXXX XXXX

Answered by Dr. T Chandrakant (3 hours later)

Brief Answer:
Thanks for your appreciation.

Detailed Answer:
Thanks for your appreciation.
Wishing you all the best.

Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar