Pudendal nerve entrapment or PNE, is a rare and debilitating condition caused by entrapment, impingement or compression of the pudendal nerve which are located within the bony pelvis, at the tips of the ischial spines. This condition affects both men and women, resulting in a variety of disabling symptoms including genital or groin pain and numbness; urinary difficulties and sexual dysfunction.The chief symptom of pudendal nerve entrapment is severe pain when sitting. Because of this, PNE is often referred to as Bicyclist Syndrome.
Overview of the Condition
Pudendal nerve entrapment was not recognized in medical literature until the 1990s. It is frequently mistaken for other conditions such as Piriformis Syndrome, sacro-iliac joint dysfunction or prostatitis. Diagnosis can prove difficult, and requires evaluation by specialists who are familiar with this specific condition, and who are skilled in diagnostic modalities such as nerve stimulation testing and magnetic resonance imaging. Treatment includes the administration of nerve blocks, surgical decompression of the pudendal nerve and physical therapy.
Goals of Exercises for PNE
Pudendal nerve entrapment causes shortening and contraction of the muscles that line and support the saddle regions of the body, also known as the pelvic floor. These areas include the buttocks, thighs, hips, and perinieum. The goal is to lengthen and loosen the muscles without causing undue stretch on the nerve. Patients should first seek the advise of their physician or a trained medical professional before attempting these exercises on their own.
Exercises for PNE
Any exercise that increases the range of motion of the affected muscles is beneficial. This includes toe touches, supine legs lifts and side leg raises where the leg is extended out and away from the mid-point of the body. These exercises help to improve range of motion and lengthen the muscles. Pulling the knee gently toward the chest from a side-lying position loosens tight buttock muscles.
Swimming pools are a great place to perform range of motion exercises. Water relieves pressure on weight-bearing joints, minimizing pain.
Kegel exercises are not recommended for patients suffering from pudendal nerve entrapment as they may aggravate symptoms and worsen pain. Resistance training is also inadvisable for the same reason. As with all physical therapy programs, consistency is needed to achieve results. The American Physical Therapy Association web site is a good resource to use to locate a physical therapist in your area who is trained in the treatment of pudendal nerve entrapment.