Pudendal Nerve Entrapment/Neuropathy/Damage

@richmond54660 Hi I just read your article . I have been toying with the idea of enzymes. I have low back pain nerve pain and knots in my thigh muscles. I believe the MFR would help and also the enzymes. I do have Nattokinase at home so will start on this I do a lot of research and use vitamins and herbals. I never used enzymes but think it will benefit me . Thanks for your article.

@skiah22 and @bkruppa and others. There were many suggestions for coping with sitting pain in old threads, above. Mine has gotten much better thanks to stretching, exercise, MFR and I found a therapist that used intense ultrasound while he does active release stretching. Recently, I've started taking some enzymes (serrapeptidase (biomedic labs) and Nattokinase (Doctor's best); both from Amazon) and these helped immensely. I believe these help the tissue remodel (compression from MFR isn't the only way to remodel the fascia - electrical (galvanic) stimulation, ultrasound, stretching, exercise can assist this process, too). However, I had a lot of stiffness and I do believe it is from deposits of fibrin in muscles, on nerves, on bursa, etc. My pain level (and stiffness) is way down after taking the enzymes I mentioned (on an empty stomach). If you are not on blood thinning medication already, it might be worth a try. That seems to be the contraindication. Also, for some reason 10-15% of Especially if you have stiffness, too. I believe that now I am mostly dealing with healing of tendons that attach to the ischeal tuberosities - hence I have some small sitting pain (which has been getting better over time). Here is a review I wrote for an enzyme product on Amazon:
Long story short I was having some myofascial pain (stiffness, sitting pain) in the legs, glutes, lower back. It’s been getting better thanks to various supplements (especailly Vitamin C with citrus bioflavinoids, quercetin / resveratrol, stretching and exercise). I also had plantar fasciitis in the feet in the past as well as some sciatica symptoms (which is due to some type of nerve compression / irritation somewhere along the nerve).

This helped along with taking nattokinase (200 U) and I worked my way up to 2 tablets of the Serrapeptase 3 times daily (one dose with the Nattokinase) Eventually, I’ll cut back to a maintenance dose and maybe use just 1 of the 80,000 U serrapeptase and 2000 U nattokinase.

While speculative, deposits of fibrin may be the culprit in causing tissue stiffness and improper tissue remodeling as you age. This may accompany (or possibly cause) conditions like plantar fasciitis, phlebitis (and some leg swelling), stiffening of the tissue - all things I am encountering. I noticed a decrease in sitting pain (i.e. less glute stiffness) right away within about four days of starting serrapeptase. On higher doses, I occasionally felt tingling in my feet while walking – but not in a painful way. More like the itching a healing wound might have. I had some areas near the ischial tuberosities that had dense areas that possibly were scar tissue-like (many years of martial arts with kicks, plyometric moves, hard landings probably contributed with this as well as possibly abnormal amounts of fibrin that were deposited on top of that as I aged – that was suggested to me by an injury massage therapist who specializes in aging athletes). Over several weeks, these became smoother and less ropey feeling. Prior massages including aggressive trigger point massage could not remove this / smooth this out. I’ve done all kinds of stretching, exercise and massage. These enzymes have been one of the most effective treatments in healing what I’ve got. Once I started on these enzymes I could feel the difference within a couple weeks. I could see some more recent scars that I have that were raised up appear flatter and remodel.

I generally research what I take and also read all the reviews from people taking these products and also scholarly articles. Based on what I’ve read, (and this is speculative – I can not state any of this as a universal medical certainty) it is quite possible that Serrapeptase can assist tissue remodeling, help remove / minimize scars / adhesions / help break up cysts, etc., including those that may irritate nerves, too. For many people, poorer healing may accompany aging. I believe this enzyme helps healing. I had no gastric irritation from either the 80,000 U version of the 260,000 U version of the enzyme. I was not recompensed in any way for this review. At some point, I'll drop down to a lower maintenance dose with the 80,000 U tablets, I suppose.

I have numbness, needle sticks and the worst nerve damage on my left side! The pain is horrible, and no one seems to understand!! I can't sleep from the pain! I pray to get better !

Hellon resawaller, I have terrible pain on my left side too from my feet, legs, arms, neck, hands and can barely walk. My diagnosis is CIDP and small cell skin neuropathy. I start infusions on the 22nd. What helps reduce my pain are cymbalta, an opiate, advil, a little exercise and ambien to help sleep. Maybe see a pain doctor to help address your pain. I feel badly for you and wish you less pain. You probably are but be aggressive in seeking medical help to stop the pain. Do you know why your having so much pain?

Hi all. I'm a new member and I have read all the posts concerning the pelvic pain. Mine started 9 years ago from no apparent reasons and I've been through all the procedures that everyone has described. I've been standing up for these 9 years trying to find a specialist that knows how to deal with this problem. Sitting is very painful but one thing that no one has mentioned in their posts is laying down is just as painful if not worse. Anyone out there that has both problems? The only way I can get any sleep is by taking prescribed medication. Otherwise, I'm awake all night long and of course the pain is there all night long.

My wife has had pudendal nerve pain for 8 years. Initially the pain was due to a bout of shingles. However, during the recovery period I believe that something new kicked in which I believe is PNE (Pudendal Nerve Entrapment) as the symptoms are identical and to me it makes sense. The pain areas in the pelvic region are exactly where the pudendal nerve goes. PNE normally is resolved by relief of any muscle or scar tissue that may be entrapping the pudendal nerve. There are many facilities around the country that treat this condition and the treatment is massaging, dialators, etc. of the muscles that could be entrapping the pudendal nerve. My wife gets some relief from this kind of treatment but it is temporary and it only helps some. We have been to many facilities including the Mayo Clinic but the doctors don't seem to recognize PNE as mostly they want to use pain meds as a course of action. We want a solution. We have tried nerve blocks in the caudal area as well as lower in the buttocks with zero pain relief.

There is a muscle group that entraps the pudendal nerve and that is the sacrotubernous ligament which can easily entrap the nerve. There are specific massaging techniques that can relieve this pressure.

Given that my wife's pain varies doctors have agreed that the nerve is not damaged. This is good news as apparently there is no treatment for a damaged nerve.

We have looked into neurostimulators. My main concern is affect on other nerves in the probe area as well as other more serious issues. I contacted two companies about their devices and neither company has any data on helping pudendal nerve issues so we would be on our own as far as what to expect. However, I had heard about paralysis as a possible side affect. Again I contacted both companies regarding the frequency of this issue but neither would respond to my requests. That was unfortunate. Then we find that a neighbor down the street from us was paralyzed due to this procedure. Now I don't want to scare people out of going through this procedure as this is a case of one out of ...............I don't know. A 100. A 1000, A 10,000. I just don't know. A doctor at Mayo told us that 20% of these need to be readjusted (surgery) within 5 years and over time they become less and less effective. Given all of the above we chose not to go through with the procedure.

Another neuro doctor is suggesting that the pain is due to inflammation of root of the pudendal nerve which resides at the spinal cord where it connects to the spinal column. Here they want to inject steroids to reduce the inflammation. Results may be nothing, good for two weeks, two months,????? They can't predict. IF this is the source then my choice would be to determine why it is inflamed at this area and resolve this issue rather than throwing meds at it.

We are also looking into inversion tables as a source of relief. The theory being that maybe her spine is shrinking due to aging and therefore entrapping the pudendal nerve. Also since she favors sitting on one side to relieve the sensitive side maybe the spine got reformed and therefore entrapping the nerve. So we will give it a try to see what happens. We have also tried acupuncture, all the suggested vitamins for neuropathy, etc., but with no success. I read a lot of articles where sugar can cause nerve pain issues to heighten so we will be doing a sugar free diet for a couple of weeks to see what happens. MRIs show nothing but a dual frequency laser treatment has helped some but for only a day or two. My wife is on gabapentin and CBD oil. CBD oil takes some of the edge off of the pain so she uses it frequently.

Scar tissue may be another cause of entrapment. Women who have an an episiotomy during child birth can develop scar tissue in this area which is close to where the pudendal nerve travels. Haven't found any doctors who buy into this theory but a lot of my wife's pain emanates from this area so I am suspect. A PT friend of mine says that when a rotator cuff is torn in the shoulder scar tissue can form around a nerve and cause pain. In these cases surgery has helped release the entrapment. However, the nerves in this area are not complex nerves like the pudendal nerve which I guess is one reason most doctors don't want to do anything invasive since they may end up causing damage to the nerve which would result in even more pain.

Sorry for the long post. However, I wanted to present everything that we have done. I would like to hear from the rest of you about what you tried and what were the results.

New member and first response here. I have had this condition (pudendal nerve entrapment) since 2012, and I have seen a number of specialists who have conducted all of the studies you mention and performed all of the procedures you mention. The end result, I'm sorry to say, is that the pain persists in much the same way as it does for your wife. I am male, and most of the specialists I have seen deal with this issue in female patients, which makes diagnoses and treatment even more difficult. For pain, I have been prescribed Diclofenac 75mg twice daily since my first (non-related) cervical spine surgery in 2009. The medication does not affect the pain in the pudendal region, and at this point my new primary care physician at Mayo is concerned about long term use in general.

I can certainly empathize with folks who have said that this condition is a 'lonely' problem, both because it is more rare in the general population and there apparently is not much data for physicians to access. It is also very difficult to have a conversation about the issue with anyone other than a physician or a family member, so I typically 'suffer in silence' most days, and feel grateful on the rare occasion when the pain is negligible for a day or so.