Hello lucy131506-ga!
I?m sorry to hear of the problems that you are having. From the
symptoms that you are describing, and from research on the web, it
appears that you may have what is called Pudendal Nerve Entrapment
(PNE). The answer is in no way intended to be a substitute for the
opinion of a qualified medical professional that you trust, so be sure
to discuss any information here as well as any other questions or
concerns that you may have with him or her.
- - - - - - - - - - - - - - - - - - -
PUDENDAL NERVE ANATOMY
According to the Family Practice Notebook website, branches of the
pudendal nerve are responsible for the sensation of the penis.
Problems along these nerves could cause the burning that you are
experiencing.
http://www.fpnotebook.com/URO8.htm
The University of Arkansas for Medical Sciences has a nice website
loaded with anatomical information. It shows that the pudendal nerve
arises from nerve roots in the spine located specifically around the
sacrum. This is the flat bone at the end of the spinal column. Nerves
coming out from the second through fourth segments (S2-S4) give rise
to what is eventually the pudendal nerve.
http://anatomy.uams.edu/anatomyhtml/ugtriangle.html
Here is an excerpt from the book ?Gray?s Anatomy? along with a diagram
of the sacrum to give you an idea of what it looks like. Nerves come
out through the holes in the front of the bone.
http://www.bartleby.com/107/24.html
- - - - - - - - - - - - - - - - - - -
PUDENDAL NERVE ENTRAPMENT (PNE)/PUDENDAL NEUROPATHY (PN)
Here is a brief description of PNE, including some of the symptoms
that one may experience.
?The pudendal nerve carries sensations from the external genitals, the
lower rectum, and the perineum (between the genitals and the anus).
Neuropathy is disease of or damage to nerves, so pudendal neuropathy
can cause symptoms in any of these areas. . . . The symptoms may
include stabbing, twisting or burning pain, pins and needles, numbness
or hypersensitivity. Usually the symptoms are made worse by sitting,
and better by either standing or lying down.
Damage to the pudendal nerve can occur suddenly as a result of trauma,
such as surgery in the pelvic region, falls, bicycle accidents, . .
.and sometimes even from severe constipation. It can also occur from
sustained trauma over time, such as from bicycle riding or aggressive
weightlifting that strains the pelvic muscles. It can be caused by
diseases such as diabetes or multiple sclerosis.?
http://www.coccyx.org/whatisit/puden.htm
Pudendal.info is a site with numerous resources for people suffering
from and wanting to learn more about PNE, or Pudendal neuropathy (PN).
From this site we get a similar description of PNE/PN.
?Pudendal Neuropathy is frequently caused by a mechanical and/or
inflammatory damage to the pudendal nerve. Such damage to the nerve
can manifest in a variety of ways, such as vague pains, stabbing
pains, burning sensations, pin pricking, numbness, twisting, cold
sensations, pulling sensations, or the feeling of sitting on a lump.
Pain is usually worse when sitting and less when standing, lying down,
or sitting on a toilet seat.?
http://www.pudendal.info/
There is more information on the same site discussing why PNE/PN
happens and why this nerve is especially prone to problems.
If your pain ?gets worse with normal sitting and better sitting on a
toilet seat, and there is no apparent reason for the pain, I'll stick
my layman's neck out and venture that you probably have PNE. . . .
The nerves stand out [prominently] on the Ischial Spine [a portion of
the pelvis]. This is why prolonged sitting (especially heavy cycling)
so frequently causes PNE. As Dr. Robert writes in his article, the
pudendal nerve ?describes a curve which drags it around the region of
the ischial spine, which it straddles like a violin string on its
bridge.??
http://www.pudendal.info/faq/IntroductoryFAQ.htm#WhatIsPNLT
Pudendal.info also has a forum where you can discuss questions,
concerns, success stories, etc. with other patients.
http://www.pudendalnerve.info/forums/pnforum/index.php
Here is a description of a few treatment options for PNE/PN, including
stretching and other forms of therapy.
?There are stretches and exercises which have provided reduced levels
of pain for some people. There are different sources of pain for
people since there are so many ligament, muscles and nerves in the
area. . . . However, there have been cases where the wrong stretches
make the constant pain worse. Some people need to strengthen the
muscles, others should stretch, while for some people it is purely
neurological. There have been cases where doing stretches have helped
bicyclists. A helpful stretch for some is bending over and touching
your toes. Another stretch includes bringing your knee to your chest
on the compressed side while lying on your back. One more possibly
helpful stretch for bicyclists include sitting in the lotus position
and moving your head to the ground supporting yourself with your hands
and keeping your buttocks up. Stretches should not be held long (about
8 seconds) and be spread out through the day. Acupuncture has helped
decrease pain levels for some people.
Chiropractic adjustments to the lower back have also helped some
patients with pudendal nerve issues.?
http://en.wikipedia.org/wiki/Pudendal_nerve_entrapment
Injections of steroids and/or anesthetic agents may also be a
treatment to consider. Local anesthetics can also be used to confirm a
diagnosis.
?At the Institute for Nerve Medicine, Dr. Aaron Filler uses open MRI
image guidance to inject anesthetic, steroid or anti-scarring
materials at the various possible entrapment points. In some cases,
injections such as these help relieve symptoms, but most often the
injections serve to confirm the diagnosis and pinpoint the cause.?
http://www.nervemed.com/nerve-pudendal.html
Here is an excerpt from an article appearing in the February 1, 2005
?Urology Times.? It discusses some ?less invasive? therapies to be
considered in PNE before undergoing surgery.
?All three experts recommended less invasive therapies before
considering surgery for PNE. Those therapies can include simple
self-care techniques, physical therapy, and pudendal nerve blocks. A
new pudendal nerve neurostimulator . . . , which is currently
undergoing feasibility trials, can be implanted percutaneously and
controlled externally.
Dr. Antolak?s self-care techniques include using a seating cushion
that suspends the perineum; avoiding athletic activity that stresses
the nerve, such as cycling; and even avoiding sitting.
Physical therapy can help resolve muscle hypertonicity, connective
tissue restrictions, abnormal biomechanical contributors, and trigger
points that may arise in external muscles and the pelvic floor as a
result or cause of this neuropathy.?
http://ut.adv100.com/urologytimes/article/articleDetail.jsp?id=147971&&pageID=2
Here is another article about PNE. It has a simple schematic diagram
showing the route the pudendal nerve takes from the spine to the
penis.
http://www.chronicprostatitis.com/pne.html
- - - - - - - - - - - - - - - - - - -
I hope that you find this information useful. While it is unlikely
that any lower back problems would be leading to the burning that you
are experiencing, it does appear that simple stretches and exercises,
taught by a physical therapist are some things that could help. Again,
be sure to discuss any further questions or concerns with a qualified
health professional that you trust. If you have any need of further
clarification, please let me know how I can help.
Sincerely,
Boquinha-ga
Search terms:
Nerve penis
Pudendal nerve
Pudendal nerve origin
Pudendal nerve entrapment
Pudendal nerve entrapment treatment |
