Pelvic pain & pudendal entrapment: can acupuncture help?


Pudendal Neuralgia is inflammation of the pudendal nerve. It is one of the nerves that starts in your low back and that connects to the following areas:

  • perineum and genitals

  • intestines and rectum

  • low back and pelvis

When it becomes inflamed and triggered, it can cause a lot of pain and embarrassing symptoms. Thankfully, acupuncture is great at reducing these!

Here's how.



Pelvic pain, pudendal neuralgia, pudendal entrapment

Symptoms

This pain can be constant or triggered during or after sexual activity, prolonged sitting, heavy lifting, hiking, or other exercise such as cycling. It can also be affected by or can directly influence urination and bowel movements. This pain can be so severe it is truly “life-altering” and is often accompanied by emotional distress and depression.


Possible symptoms include

  • burning or numbness

  • electric shock or stabbing pain

  • feeling of a lump or foreign body

  • twisting or pinching

  • abnormal temperature sensations

  • constipation and pain

  • straining or burning when urinating

  • painful intercourse

  • sexual dysfunction




Causes

There is many causes of pudendal neuralgia. It may be related to:

  • Childbirth trauma

  • Gynecological or colo-rectal surgery

  • Cycling, Excessive physical exercise

  • Past pelvic or perineal trauma

  • Injury

  • Repeated straining on the toilet

  • Musculoskeletal issues

  • Posture

  • Stress




Acupuncture for pelvic pain is very efficient


Releasing the nerve root

In the case of pudendal nerve entrapment, we will focus on the root cause of the problem, literally located at the nerve root in your lower spine. The effects of acupuncture on pain have been demonstrated time and time again.


Local trigger points

A trigger point is a sensitive, painful area in a muscle, coming from fibers bunching up and tightening, or from nerve signals not traveling properly.


During a treatment, we might target

trigger points in the legs, buttocks and low back , which can all affect pelvic alignment and create internal pelvic pain.

  • Iliopsoas

  • Quadratus Lumborum

  • Hamstrings

  • Obturator Internus

  • Adductors

  • Piriformis

  • Gluteal muscles


The pain from these trigger points can result in perineum, testicular, internal and external genitals, groin pain, bladder pain and burning sensations. Releasing the trigger points with acupuncture needles usually provides relief.


The jaw, TMJ & the connection to our pelvic floor

Chinese medicine views the body as an interconnected network. The jaw and the pelvis are mirror images of each other, and releasing one often benefits the other.

Across disciplines, body workers have observed for a long time a correlation between TMJ and pelvic floor dysfunctions. Misalignment of the jaw causes misalignment of the pelvic floor. We hold a lot of repressed tension in the jaws and in the pelvis, and acupuncture can open both up gently.


Acupuncture is fantastic at releasing the jaw and reducing TMJ dysfunction (read our blog article here), and the benefits will therefore trickle down to the pelvis.


Chinese herbs for pelvic dysfunction

  • Liver meridian cold stasis

In TCM, the liver meridian wraps around the genitals and the perineum. We will be targeting it with the acupuncture treatment but also with herbs that warm it up and release it.

Liver channel cold signs include: genital and groin pain, twisting pain etc.

Useful herbs: Wu Zhu Yu Tang

  • Jing Stagnation

Jing is your "life essence" which resides in the kidneys, and impacts reproductive functions. If it is stagnant, it can create symptoms like erectile dysfunction, low libido and pain.

Useful herbs: Huo Xue Tong Jing Tang, Dang Gui, He Shou Wu, Yi Mu Cao, Ji Xue Teng, etc..


What you can do at home


We often will refer our pelvic floor pain patients to a pelvic floor physical therapy specialist, to work together.


Castor oil packs or massages for muscle spasms

People have found relief from pelvic floor muscle spasms by using castor oil topically.

  • Soak a cotton rag or old t-shirt in warm castor oil and apply the cloth to the painful area.

  • The oil is rubbed around the rectum, up the tailbone, and around the sacrum, and left for 10-20 minutes before removal.

Magnesium supplements & Epsom salt baths

Magnesium is crucial for proper nerve and muscle function. It is really important to supplement when working with any kind of muscle spasm.

Epsom salt contains a lot of magnesium, and adding it to your hot bath water helps a lot with muscle spasms and general relaxation.


Bowel and bladder management strategies:

  • Try not to strain when eliminating, as this stretches the nerve.

  • Buy a "squatty potty" type of bench for the bathroom

  • Avoid stimulant laxatives that create dependence

  • Physiotherapy can help you




Modify your Sitting posture

Avoiding pressure on the perineum (the area inside your ‘sit bones’) helps to prevent the nerve compressing. You can buy special coccyx-cut-out memory foam cushions and modify them to remove the section under your perineum, so that when you sit you won’t take any weight there.

Decreasing your sitting can also help – try standing at your desk for part of the day using a laptop on a box or a portable desk raiser.


Avoiding physical activities that irritate the nerve:

  • cycling

  • horse-riding

  • trampoline jumping

  • bench pressing

  • excessive ‘core muscle’ exercises


And do not forget to talk to your acupuncturist. Pelvic pain can get better !


No matter where you are in your pain management journey,

if you need support, we can help.

In addition to our own team of specialized acupuncturists, we are well-connected within the Los Angeles- Pasadena area community to help you

find the right integrative and holistic care for you.

On our website, you can learn more about our services, and book an appointment.

If you have more questions please call our front desk, at 626-841-2991, or email us.

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