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Diagnosis and Conservative Chiropractic Care of Chronic Idiopat hic Pudendal Nerve Entrapment Causing Saddle-Like Paresthesia and Restless Genital Syndrome: A Case Study

Abstract

Harold Michael Olson

Introduction: To describe and discuss the diagnosis and chiropractic treatment of a patient with chronic idiopathic pudendal nerve entrapment that presented with saddle-like paresthesia and caused Restless Genital Syndrome.

Aim: A 43-year-old female patient had symptoms consistent with a pudendal nerve entrapment, saddle-like paresthesia, and restless genital syndrome for 1.5 years prior to starting care with a chiropractor. She had been to numerous medical providers, none of which offered the correct diagnosis or treatment options.

Methods and Results: Chiropractic manipulative therapy, myofascial release, and instrument-assisted soft-tissue mobilization was directed at the pelvic musculature with the primary focus on the right obturator internus. Through one month of chiropractic care the patient’s symptoms were resolved including restoration of regular sexual function.

Conclusion: Chronic perineal pain can be found in cases with numerous diagnoses, with pudendal nerve entrapment being one that is rarely documented. There are a wide variety of causes of PNE that include but not limited to direct injury, tumor, ganglion cysts, anatomical anomaly, and extended time cycling. Documented treatment for pudendal nerve entrapment is limited, primarily to pain injections. This case demonstrates how chiropractic care and soft tissue mobilization can correct the dysfunction.