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Pudendal Neuralgia
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Symptoms of a Pudendal Neuralgia Diagnosis:

A Pudendal Neuralgia diagnosis has been described as throbbing or severe stabbing pain along the pathway of the pudendal nerve that runs through the gluteal, pudendal canal and perineal region. This pain typically increases during sitting and is reduced or relieved by sitting on a toilet seat.

There are five essential criteria for a pudendal neuralgia diagnosis:

  • Pain in the anatomical territory of the pudendal nerve
  • Worsened by sitting
  • The patient is not woken at night by the pain
  • No objective sensory loss on clinical examination
  • Positive anesthetic pudendal nerve block.

Other criteria that are considered complimentary include: burning, shooting, stabbing pain or numbness, allodynia, sensation of a rectal or vaginal foreign body (sympathalgia), worsening of the pain during the day, pain predominantly on one side, pain triggered by bowel movements, and tenderness to palpation along the ischial spine (on clinical exam). Associated signs and symptoms that may also be present are: buttock pain on sitting, referred sciatic pain, pain referred to the medial aspect of the thigh, suprapubic pain (pain above the pubic bone), frequent urination, pain with a full bladder, pain ocurring after ejaculation,pain during or after intercourse (dyspareunia), erectile dysfunction.

There is no sensory loss on clinical examination and an anesthetic pudendal nerve block is positive. Patients are not woken at night by pain, but do have pain during waking hours. Other clinical criteria can provide additional arguments in favor of the diagnosis of pudendal neuralgia, such as painful bowel movements or a feeling of fullness in the vaginal canal or rectum. This has also been termed Cyclists' Syndrome when it occurs in long-distance cyclists.

Contact us with any questions you may have about your Pudendal Neuralgia diagnosis. We have a number of treatment options available!

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Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

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