Pelvic floor pain can be a complex and debilitating condition, significantly impacting a person's quality of life. While many factors can contribute to pelvic pain, one often-overlooked cause is nerve entrapment. This occurs when a nerve gets compressed or irritated by surrounding tissues, leading to a variety of symptoms including burning, shooting pain, numbness, or tingling in the pelvic region. Pelvic floor physiotherapy Edmonton At Next Step Physiotherapy , our specialized pelvic floor physiotherapists are highly skilled in diagnosing and treating nerve entrapments that contribute to pelvic pain, offering a pathway to relief and improved function.
Understanding Nerve Entrapments and Pelvic Floor Pain
Several nerves can become entrapped in the pelvic region, leading to different patterns of pain and dysfunction. The most commonly implicated nerves include:
Pudendal Nerve: This is perhaps the most well-known culprit in pelvic nerve entrapment. The pudendal nerve supplies sensation to the genitals, perineum, and rectum, and controls muscles in the pelvic floor. Entrapment can occur at various points along its path (e.g., Alcock's canal) due to trauma, prolonged sitting, childbirth, surgery, or overuse. Symptoms often include burning, shooting, or aching pain in the sitting bones, perineum, rectum, or genitals, which often worsens with sitting and improves when standing or lying down.
Obturator Nerve: This nerve provides sensation to the inner thigh and controls some adductor muscles. Entrapment can cause pain in the groin, inner thigh, and sometimes into the knee, often exacerbated by hip movements.
Ilioinguinal, Iliohypogastric, and Genitofemoral Nerves: These nerves supply sensation to the lower abdomen, groin, and upper thigh. Entrapment can lead to burning or numb pain in these areas, sometimes after abdominal surgery or direct trauma.
Sciatic Nerve: While primarily associated with leg pain, high sciatic nerve compression or irritation from deep gluteal muscles (e.g., piriformis syndrome) can cause referred pain into the buttock and pelvic region, mimicking or coexisting with pelvic floor dysfunction.
Why is diagnosis challenging? Pelvic pain is notoriously complex because symptoms can overlap with other conditions like muscle dysfunction, bladder issues, or gynecological problems. Nerve entrapment is often a diagnosis of exclusion or one that requires a highly specialized assessment.
Diagnosing Nerve Entrapment at Next Step Physiotherapy
At Next Step Physiotherapy in Edmonton, our pelvic floor physiotherapists are uniquely qualified to assess and diagnose nerve entrapments contributing to pelvic pain. Our diagnostic process includes:
Detailed History: A thorough discussion of your symptoms, their onset, aggravating and alleviating factors, medical history, and any relevant lifestyle factors. This is crucial for identifying patterns suggestive of nerve involvement.
Comprehensive Physical Examination:
External Assessment: Evaluating posture, hip mobility, lumbar spine function, and assessing for muscle imbalances in the core and lower extremities.
Internal Pelvic Floor Assessment: (with patient consent) This is often vital. Our therapists can gently palpate specific areas internally to assess for tenderness along nerve pathways, muscle tension, and trigger points in the pelvic floor muscles that might be compressing nerves.
Neurological Testing: Assessing sensation, reflexes, and muscle strength in areas supplied by the suspected nerves.
Provocation Tests: Specific movements or positions designed to reproduce your symptoms, helping to pinpoint the irritated nerve.
Physiotherapy Solutions at Next Step Edmonton
Once a nerve entrapment is suspected or confirmed, your personalized physiotherapy treatment plan at Next Step Physiotherapy will focus on:
Nerve Mobilization/Gliding: Gentle exercises and manual techniques to encourage the entrapped nerve to move freely within its surrounding tissues, reducing compression and irritation.
Manual Therapy: Addressing muscle tension, fascial restrictions, and joint dysfunctions (e.g., in the hips or lower back) that may be contributing to nerve compression.
Pelvic Floor Muscle Retraining: For hypertonic (overly tight) pelvic floor muscles that might be compressing nerves, we focus on relaxation techniques, downregulation exercises, and diaphragmatic breathing. If weakness is also present, gentle strengthening might be introduced carefully.
Postural and Biomechanical Correction: Identifying and correcting any movement patterns, sitting habits, or activities that contribute to nerve irritation. This includes ergonomic advice.
Pain Education: Understanding chronic pain and nerve pain mechanisms can empower you to manage your symptoms more effectively and reduce fear-avoidance behaviours.
Adjunctive Therapies: Depending on the individual, dry needling might be used to release stubborn muscle trigger points, or gentle modalities to reduce inflammation.
Home Exercise Program: Providing specific stretches, nerve glides, and relaxation exercises to continue your progress between sessions.
Dealing with pelvic floor pain, especially when nerve entrapment is suspected, requires specialized care. At Next Step Physiotherapy in Edmonton, our dedicated pelvic floor physiotherapists offer expert diagnosis and evidence-based treatment, helping you understand and overcome this challenging condition. Don't suffer in silence – reach out to us for a comprehensive assessment and a clear path to relief.
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