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A 25-Year-Old Cyclist with Persistent Perineal Pain

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Practical Chronic Pain Management

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Abstract

Pudendal neuralgia is an uncommon, painful condition caused secondary to inflammation or entrapment of the pudendal nerve. The prevalence of pudendal neuralgia is reported at 1:100,000 but is often underdiagnosed. This pain is described as a pain along the perineum radiating to the genitals with associated numbness and in some cases erectile dysfunction. Diagnosis of this condition is one of exclusion with available diagnostic criteria and complementary diagnostic neurophysiologic testing or imaging. Diagnosis of pudendal neuralgia or entrapment is oftentimes delayed secondary to clinical signs which overlap with other conditions. Treatment options range from conservative medical management with anti-inflammatory or neuropathic pain medications, interventional pain therapies with pudendal nerve blocks and radiofrequency ablation, and ultimately surgical decompression. Adjunct therapies include stretching, cessation of exacerbating activity, and adjustments to cycling equipment.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Kansas University Medical Center, Kansas City, KS, USA

    David H. Kim

  2. Department of Anesthesiology, Rush University, Chicago, IL, USA

    Arjun Ramesh

  3. Department of Anesthesiology and Pain Management, Illinois Bone & Joint Institute, Morton Grove, IL, USA

    Adam C. Young

Authors
  1. David H. Kim
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  2. Arjun Ramesh
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  3. Adam C. Young
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Corresponding author

Correspondence to Adam C. Young .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA

    Tariq Malik

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Kim, D.H., Ramesh, A., Young, A.C. (2020). A 25-Year-Old Cyclist with Persistent Perineal Pain. In: Malik, T. (eds) Practical Chronic Pain Management. Springer, Cham. https://doi.org/10.1007/978-3-030-46675-6_38

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  • DOI: https://doi.org/10.1007/978-3-030-46675-6_38

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-46674-9

  • Online ISBN: 978-3-030-46675-6

  • eBook Packages: MedicineMedicine (R0)

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