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what clinic 2013

Sayer Clinics > News

Michael Durtnall’s success in treatment of Pudendal Neuralgia and Inferior Cluneal Neuralgia sitting pain.

Successful cures of Pudendal Neuralgia and Inferior Cluneal Neuralgia sitting pain.

 

Painful sitting has become a common condition of men and women with pelvic pain with the Pudendal Nerve the most likely suspect if pelvic pain is located jon one or both sides of the perineum, labia, and clitoris in women or pelvic floor, testicles and penis in men caused by Pudendal nerve compression or entrapment. 

 

Pudendal neuralgia (PN) or pudendal nerve entrapment (PNE) needs careful examination of nerves, muscles, ligaments, pelvic asymmetry from leg length difference, sacroiliac joint and/or tailbone dysfunction or pain with essential assessment of pelvic myofascia and external and internal ligaments potentially entrapping or compressing one or both Pudendal nerves.

 

Occurring more in women than men, sacroiliac joint and postural dysfunction following falls, pelvic injuries, childbirth, wearing high-heels or habitual sitting asymmetrically, possibly to avoid hip, groin or tail bone pain, may result in pudendal neuralgia. 

 

However, if sitting causes burning pain under the sitting-bones with a broad, painful, prickling pain sensation of the perineum, sex organs, back half of the pelvic floor, inner lower buttock inwards to the anus and potentially radiating down the back of the thigh, it is potentially due to compression of the Inferior Cluneal Nerve branch of the Posterior Femoral Cutaneous Nerve (PFCN).  

 

If this nerve is compressed from chronic sitting, slumped backwards, with direct pressure or sideways-sitting shearing pressure on the nerve, this can cause pain in the perineum, labia and vagina (for women) or pain in the perineum, penis and testicles (for men) which mimics pudendal neuralgia and causes diagnostic confusion.

 

I often see Inferior Cluneal neuralgia in patients who have had to drive for long or repeated journeys to visit an ill relative or in post-grad MSc and PhD students who have been studying for exams or writing their thesis for many months, sitting for many long hours every day in bed or on a sofa.

 

Treatment specifically to rehabilitate these tissues is our team's specialisation with manual therapy, specific exercises and postural training on how to sit to avoid continued pressure on the Inferior Cluneal nerve from slumped sitting.

 

Sayer Clinics’ specialist pelvic physical therapy, shiatsu and acupuncture team help cure myofasial pain syndromes.

 

The very few who cannot be helped by physical and manual therapy are referred without delay to the very best Pudendal pelvic surgical specialists in France or Spain.

 

Sayer Clinics’ founder and Chairman, Dr Michael Durtnall, is expert in Diagnostic Assessment, Manual Manipulation and Posturology and essentially, also advises his patients on pilates, yoga, sports and specific activity to regain free movement of internally constricted nerves as well as improving balance, strength, symmetry and flexibility which ultimately make us fit, healthy, joyful and pain-free.

 

Differential Diagnosis of Inferior Cluneal Neuralgia, Posterior Femoral Cutaneous Neuralgia (PFCN), Pudendal Neuralgia (PN) and Pudendal Nerve Entrapment (PNE).

 

Gynaecologic           Endometriosis, Pelvic inflammatory disease, PCOS, Pelvic adhesions, Vulvodynia


Obstetric                 Childbirth injury, Forceps or Ventouse injury


Musculoskeletal      Sacroiliac, Coccyx, Pudendal neuralgia, PN, myofascial pain,, Ischial bursitis


Urologic                   Interstitial cystitis, Pelvic Radiation therapy


Gastrointestinal      Irritable bowel syndrome IBS, Abdominal Adhesions