what a wonderful presentation...following their wonderful book. One of the hardest parts of having PN for me is dealing with pelvic floor physios who do not know the condition---and the myriad ways this can be harmful physically and emotionally (and financially). It is so validating and hope inspiring to hear Stephanie speak with such knowledge and professional approach to this condition. This is head and shoulders above the norm. Thank you!
I just watched this webinar and I have to say it is one of the most useful summaries of the minefield of information that is available on pudendal neuralgia. I have read hundreds of these trying to get a handle on how to proceed with my symptoms. Well done Stephanie, I finally understand a lot more than I did an hour ago!!!!!
John, thank you for this wonderful comment! We are so happy to hear that it has been knowledgeable and helpful for you! We hope you enjoy the other webinars we have on here as well.
I've suffered long from Pudendal neuralgia, PFD, sitting pain, SI joint pain, etc. I've been through PT after PT that just discharge within 90 days. They give up. No suggestions, no referral, so long farewell, good luck. Hope you mentioned? I gotta admit, not a whole lot of that anymore. When I started PFPT I did. I also have Ehlers Danlos and its slowly getting worse despite fighting medical providers for treatment & getting frequently gaslighted. I'm not seeking medications, I'm intolerant to most anyways. What can I do? The only thing I ever hear is endless PT. Pain management? PN blocks gave me permanent incontinence until it wore off. I'm scared to death of the PN rf ablation for this reason. There has to be something I can do.. sadly most the PFPT's I went to knew almost nothing of Ehlers Danlos or its treatment either. Doctors? Have honestly been no help at all. If medications don't work, they don't want to see you, at least here.
Doreen, I am so sorry to hear you are struggling. In our clinical experience the most effective treatments are a combination of medical management (medications and potentially procedures) and pelvic floor physical therapy. The strategy and sequence of therapies matters. I encourage you not to give up, there is always another way to get better in our opinion. We are available for digital health and in-person appointments if you would like to discuss your specific situation with us in more detail and we can try to help: www.pelvicpainrehab.com.
Thank you for the great presentation. You have mentioned pudendal neuralgia can affect central nervous system. What kind of changes to the central nervous system, can you some examples? Thank you
Persistent pain issues result in changes in the brain and spinal cord that cause our pain thresholds to lower and can reduce our ability to inhibit pain effectively. Examples of functional activities that people may notice are reduced sitting tolerances, inability to tolerate clothing, or flare- ups from seemingly benign things such as walking.
I have pudendal neuralgia and one of the symptoms I find most difficult to deal with is the vaginal foreign body sensations (sympathalgia). It gives me a real uncomfortable feeling all day long, als if I prolapse, which is not the case, as it has been ruled out by multiple specialists. It's triggered when I sit, walk or stand. It is usually not mentioned in treatment options. It seems no PTs, specialist or anyone else can explain to me if this can be treated, and maybe even more important, if it is a type of neuropathic pain or due to tight PF muscles, and if this sensation can be reduced when reducing central sensitization, or if there is any pain medication working for this. Is there any particular information on how to treat this particular aspect of symptoms?
You are correct that this is rarely discussed. It can be due to tight pelvic floor muscles, because contracted muscles occupy a different shape and feel different than lengthened muscles. It can also be due to the nervous system misinterpreting signals from the pelvis. Pelvic PT and other treatments for central sensitization should help. I would ask a pain specialist your question about medications.
Hi Emily, we start with a thorough history, if manual examination and treatment is not yet appropriate we identify this during the evaluation and then work with the medical team until it is. There are multiple ways to help people improve and each person's situation is unique.
Does it cause groin , leg and feet pain along with vaginal pain?... Please inform me about this as I am so confused that what kind of disease I m suffering from.
The pudendal nerve supplies sensory, motor and autonomic control in the pelvis. However, many people with pudendal neuralgia also have myofascial, biomechanical, and central nervous system issues that can cause pain in the lower extremities and feet.
Burning on the skin of the areas the pudendal nerve innervates could be due to pudendal neuralgia. It would also be important to rule out other potential causes of pain, such as a hormonal insufficiency or a dermatological condition.
@@cristinahz It may explain the symptoms, if you are deficient enough in estradiol and/or testosterone. The solution would be to supplement with local estradiol/testosterone. I would recommend seeing your gyn and testing your hormone levels to determine what your hormone status is. Additionally, if you are deficient, there would likely be some visual signs, such as redness or pallor. This is something that a gyn should be able to determine with an exam. Some pelvic floor PTs will also feel confident in assessing your vulvar tissues for this as well.
@@PelvicHealth I am from Romania, we don't have pelvic floor PT, just general PT. Do you have some examples of exercises that could improve some symptoms?
@@cristinahz Hi! Without an evaluation, we can't recommend specific exercises as we would want to ensure the exercises are right for your specific pelvic health. You are welcome to schedule a telehealth appointment with us if you would like to discuss your case & potential exercises. Otherwise we recommend checking out our other videos & our blogs on our website for this topic! pelvicpainrehab.com/telehealth/
what a wonderful presentation...following their wonderful book. One of the hardest parts of having PN for me is dealing with pelvic floor physios who do not know the condition---and the myriad ways this can be harmful physically and emotionally (and financially). It is so validating and hope inspiring to hear Stephanie speak with such knowledge and professional approach to this condition. This is head and shoulders above the norm. Thank you!
Thank you for watching and listening along to our presentation. We appreciate your kind words! ❤
I just watched this webinar and I have to say it is one of the most useful summaries of the minefield of information that is available on pudendal neuralgia. I have read hundreds of these trying to get a handle on how to proceed with my symptoms. Well done Stephanie, I finally understand a lot more than I did an hour ago!!!!!
John, thank you for this wonderful comment! We are so happy to hear that it has been knowledgeable and helpful for you! We hope you enjoy the other webinars we have on here as well.
Thank you very much for all the information and support ❤
You are welcome!
super info Merci🎊🎁
Fantastic information.
Thanks so much
Our pleasure!
I've suffered long from Pudendal neuralgia, PFD, sitting pain, SI joint pain, etc. I've been through PT after PT that just discharge within 90 days. They give up. No suggestions, no referral, so long farewell, good luck. Hope you mentioned? I gotta admit, not a whole lot of that anymore. When I started PFPT I did. I also have Ehlers Danlos and its slowly getting worse despite fighting medical providers for treatment & getting frequently gaslighted. I'm not seeking medications, I'm intolerant to most anyways. What can I do? The only thing I ever hear is endless PT. Pain management? PN blocks gave me permanent incontinence until it wore off. I'm scared to death of the PN rf ablation for this reason. There has to be something I can do.. sadly most the PFPT's I went to knew almost nothing of Ehlers Danlos or its treatment either. Doctors? Have honestly been no help at all. If medications don't work, they don't want to see you, at least here.
Doreen, I am so sorry to hear you are struggling. In our clinical experience the most effective treatments are a combination of medical management (medications and potentially procedures) and pelvic floor physical therapy. The strategy and sequence of therapies matters. I encourage you not to give up, there is always another way to get better in our opinion. We are available for digital health and in-person appointments if you would like to discuss your specific situation with us in more detail and we can try to help: www.pelvicpainrehab.com.
Thank you for the great presentation. You have mentioned pudendal neuralgia can affect central nervous system. What kind of changes to the central nervous system, can you some examples?
Thank you
Persistent pain issues result in changes in the brain and spinal cord that cause our pain thresholds to lower and can reduce our ability to inhibit pain effectively. Examples of functional activities that people may notice are reduced sitting tolerances, inability to tolerate clothing, or flare- ups from seemingly benign things such as walking.
I have pudendal neuralgia and one of the symptoms I find most difficult to deal with is the vaginal foreign body sensations (sympathalgia). It gives me a real uncomfortable feeling all day long, als if I prolapse, which is not the case, as it has been ruled out by multiple specialists. It's triggered when I sit, walk or stand. It is usually not mentioned in treatment options. It seems no PTs, specialist or anyone else can explain to me if this can be treated, and maybe even more important, if it is a type of neuropathic pain or due to tight PF muscles, and if this sensation can be reduced when reducing central sensitization, or if there is any pain medication working for this. Is there any particular information on how to treat this particular aspect of symptoms?
You are correct that this is rarely discussed. It can be due to tight pelvic floor muscles, because contracted muscles occupy a different shape and feel different than lengthened muscles. It can also be due to the nervous system misinterpreting signals from the pelvis. Pelvic PT and other treatments for central sensitization should help. I would ask a pain specialist your question about medications.
How do you treat this stuff in PT when someone has PGAD and cant be touched?
Hi Emily, we start with a thorough history, if manual examination and treatment is not yet appropriate we identify this during the evaluation and then work with the medical team until it is. There are multiple ways to help people improve and each person's situation is unique.
Does it cause groin , leg and feet pain along with vaginal pain?... Please inform me about this as I am so confused that what kind of disease I m suffering from.
The pudendal nerve supplies sensory, motor and autonomic control in the pelvis. However, many people with pudendal neuralgia also have myofascial, biomechanical, and central nervous system issues that can cause pain in the lower extremities and feet.
What if the burning is just on the skin in those areas?
Burning on the skin of the areas the pudendal nerve innervates could be due to pudendal neuralgia. It would also be important to rule out other potential causes of pain, such as a hormonal insufficiency or a dermatological condition.
@@PelvicHealth I know I am in perimenopause, can this only explain these symptoms? And what is the solution then?
@@cristinahz It may explain the symptoms, if you are deficient enough in estradiol and/or testosterone. The solution would be to supplement with local estradiol/testosterone. I would recommend seeing your gyn and testing your hormone levels to determine what your hormone status is. Additionally, if you are deficient, there would likely be some visual signs, such as redness or pallor. This is something that a gyn should be able to determine with an exam. Some pelvic floor PTs will also feel confident in assessing your vulvar tissues for this as well.
@@PelvicHealth I am from Romania, we don't have pelvic floor PT, just general PT. Do you have some examples of exercises that could improve some symptoms?
@@cristinahz Hi! Without an evaluation, we can't recommend specific exercises as we would want to ensure the exercises are right for your specific pelvic health. You are welcome to schedule a telehealth appointment with us if you would like to discuss your case & potential exercises. Otherwise we recommend checking out our other videos & our blogs on our website for this topic! pelvicpainrehab.com/telehealth/
do you guys see/treat many (male) cyclists ?
Yes, we do see many cyclists. If you are interested in scheduling with us you can find out contact info here: pelvicpainrehab.com/locations