Proof That Healing from Pudendal Neuralgia is Possible

Meet Helen. Helen is from Paris, France and has undergone an extensive healing journey battling PN. She came to us over a year ago with 9/10 R-sided pelvic/vaginal/ischial tuberosity pain, high anxiety and significant functional restrictions—including the inability to sit. We now say goodbye to Helen as she heads back to France once and for all 95% pain-free!

In Helen’s case, we found that her right pudendal nerve was a victim of dysfunctional pelvic floor muscles with severe hypertonicity particularly of the obturator internus, the iliococcygeus, and the piriformis. These, in turn, were dysfunctional due to multiple issues including coccyx dysfunction, a pelvic obliquity, poor force closure of the pelvis, faulty breathing patterns, and multiple issues throughout her lower kinetic chain. The viscerosomatic reflex was also at play with significant connective tissue restriction noted around the bony pelvis, spine, hips and lower extremities.

Our first step in treatment was to down regulate her highly up regulated nervous system and educate her on pain science (which was a little tricky at times due to our language barrier!) Recall, the pelvic floor is under the autonomic nervous system’s regulation. So when a patient comes in in a highly up-regulated state—with the sympathetic nervous system in overdrive—the pelvic floor will not respond well (if at all) to manual therapy until this is addressed.

Once her nervous system was in a more calm state, we moved to addressing the above dysfunctions. As we peeled away the multiple layers of her presentation, it was noted her right obturator internus muscle had significant refractory muscle spasm. We were fortunate to have amazing colleagues back in France to collaborate with (it always takes a village)! Helen underwent Botox to her right obturator internus with the renowned Dr. Eric Bautrant. This was an essential treatment piece needed to further take tension off her right PN and allow it to fully heal.  Helen returned to the US and spent a subsequent six months with us and is now ready to head home essentially pain-free with new movement strategies to boot!