Genital Pain / Pelvic Floor / Levator Ani Syndrome / Pudendal Neuralgia


Trigger points can prohibit the involved muscles from building mass (i.e. strengthening) and almost always, excessive exercise to the involved muscles is contraindicated

The involved muscles must have their TrPs removed and the muscle 'normalized', before a strength-building exercise routine is started. Failure to follow this Trigger Point protocol typically leads to perpetuation or exacerbation of symptoms. 


Thigh muscles

The adductor magnus (thigh adductor) TrPs often cause groin pain that is typically felt inside the pelvis. This pain may be diffuse or may be a sudden sharp explosion of pain at the pubic bone, the vagina, rectum, or rectal area (proctalgia fugax), prostate or bladder.

Many clients find that their chronic bladder issues such as frequency or urgency, are greatly reduced or eliminated once we remove the Pelvic Floortrigger points from their abdominal muscles. 


Intrapelvic muscles

Trigger points in the intrapelvic muscles (pelvic floor muscles) are known to refer pain to the bladder, low back, rectum, tailbone, genitals, urethra, perineum, and the very upper posterior thigh. The vagina is commonly affected and these TrPs (when active) can also contribute to menstrual pain and/or painful intercourse. 

Men might experience prostate and impotence issues when active intrapelvic TrPs are present. Both genders might experience painful bowel movements from these internal, pelvic floor trigger points.

Other issues in the abdomen and pelvic areas that may have abdominal trigger point origins are;  Groin pain/ache, and genital pain (ovaries, vagina, penis and testicles). 

Access to these pelvic floor trigger points is sometimes through the rectum or vagina (intrapelvic). Keep in mind that all external treatment options should be exhausted prior to considering an intrapelvic treatment. Even then treatment is best employed by an extensively trained Trigger Point expert.

Chronic pain and discomfort around the genitals, rectum and perineum, often are caused by active trigger points in the pelvic floor muscles that include levator ani, obturator internus, iliococcygeal and other pelvic floor /wall muscles.

NOTE: Discomfort to the dorsal area (clitoral area) of the genitals or the scrotal area, may be caused by entrapment of the genitofemeral nerve where it passes through the psoas major muscle. The psoas major muscle should also be checked for TrPs if you suffer from this symptom.

Pudendal Neuralgia (PN)


The pudendal nerve runs through the gluteus muscles (the buttocks) and into the perineum (think of the perineum as any part of the body that touches a bicycle seat). Pudendal neuralgia is a disorder of the pudendal nerve that can lead to chronic pelvic pain. It may be caused by pudendal nerve entrapment when the nerve becomes compressed, or by damage to the pudendal nerve itself. It is also known as pudendal neuropathy.


Causes of Pudendal Neuralgia:
Chronic pelvic pain from pudendal neuralgia can be caused by any of the following:
*diabetic neuropathy
*trauma to the buttocks or pelvis -- including childbirth
*excessive sitting (cyclists often have pudendal nerve entrapment)
*thickening of ligaments around the pudendal nerve
*bony formations pushing against the pudendal nerve
** Myofascial Trigger Points may be the underlying cause of Pudendal Neuralgia symptoms.


Pudendal Neuralgia Symptoms:
Pudendal nerve pain may be described as burning, numbness or pins and needles, stabbing or cramping.
It may present in any of the following ways:

*pain in the perineum or anal region
*in men, pain in the penis or scrotum
*in women, pain in the labia or vulva
*pain during intercourse
*pain when urinating or having a bowel movement
*pain in sitting that goes away when standing
Because the symptoms are often hard to distinguish, pudendal neuropathy can often be hard to differentiate from other types of chronic pelvic pain, such as prostatitis and vulvodynia.

NOTE: Discomfort to the dorsal area (clitoral area) of the genitals, and the scrotal area, may be caused by compression of the genitofemeral nerve where it passes through the psoas major muscle. This muscle should also be checked for TrPs if you suffer from this symptom. 


**Unawareness of trigger points that cause internal pelvic pain can lead to a wide array of mistaken diagnoses and unnecessary surgery

Our office is closed on weekends and holidays. To book your appointment for treatment, or for more workshop information:
Phone: 250.714.6056                                                           Email: info@triggerpoint.ca             1455 Townsite Rd. Nanaimo, BC V9S 1M9
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