Objective: The purpose of this case report is to describe and discuss the management of pudendal neuralgia utilizing a multimodal chiropractic treatment approach.
Clinical Features: A male patient sought care for 3 years of ongoing left sided medial gluteal pain and genital paresthesia in which he thought to be caused from an intense squatting workout. The patient had remained refractory to prior treatments including a regimen of antibiotics, pelvic floor therapy, conventional physical therapy, and activity modification. Provoking activities included urination, ejaculation, physical activity, sitting, and bowel movements.
Intervention and Outcome: Multimodal chiropractic intervention, including spinal manipulative therapy, instrument-assisted soft-tissue mobilization (IASTM), manual myofascial release, cupping, and an at home stretching program focusing on tension in the obturator internus muscle. The patient reported near resolution of symptoms after 7 treatment sessions and complete abolition of symptoms following one month adherence to at home exercises.
Conclusion: Conservative management for pudendal neuralgia is not well documented within the literature. This case provides preliminary evidence, at best, for the use of multimodal chiropractic intervention for pudendal neuralgia and suggests that further research is needed in this area.
Author keywords: Pudendal Nerve; Neuralagia
Author affiliations: KP: Private practice of chiropractic, Victorville, CA; MO: Bigfork Valley Hosital, Bigfork, MN; TM: Palmer College of Chiropractic, Davenport, IA; NH: VA Central Iowa Healthcare Systems, Des Moines, IA
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