What Causes Pudendal Nerve Entrapment (Pelvic Pain)?
Pudendal nerve entrapment, also known as Alcock’s canal, occurs when the pudendal nerve (which carries signals to and from the genital and anal area) becomes damaged, compressed or entrapped. This causes pudendal neuropathy, or pelvic pain, which can worsen when sitting or as the day progresses. Other symptoms can include genital numbness (or increased sensitivity), fecal and urinary straining or incontinence, and sexual dysfunction.
Causes of pudendal nerve entrapment include pregnancy, accidents, infection and inflammation, and scarring from surgery or surgical mishaps. Scar tissue is not as flexible as healthy tissue, and the gradual build-up and thickening of scar tissue can narrow and constrict the anal or rectal canal, resulting in a stricture, compressed ligaments, or compressed or trapped pudendal nerve.
The pudendal nerve can also fuse or adhere to different parts of the anatomy, or become trapped between the sacrotuberous and sacrospinalis ligaments. Prolonged bicycling, especially on an incorrectly positioned bicycle seat, may eventually thicken the sacrotuberous and/or sacrospinous ligaments and trap the pudendal nerve between them.
Natural Remedies For Pudendal Nerve Entrapment (Pelvic Pain)
NOTE: This Home Remedy Page provides only basic information about natural treatment for pudendal nerve entrapment and pelvic pain. Check out my book, Jini’s Healing Guide: Rectal Spasm, Prolapse & Pain for complete, detailed instructions and dosages.
Remedies For Pain, Spasm or Cramping
If you suffer from rectal muscle spasming or cramping, there are a number of tools you can use to relax the rectal muscles and ease the pain. The spasming often occurs when you have a build-up of stool and you need to poo. But once your rectum goes into spasm, it prevents the stool from coming out, so you get into a really unpleasant feedback loop of need to poo → pressure causes spasm → can’t poo → more build-up of poo → urgency to poo increases → increased pressure causes stronger spasm, and so on.
You may also experience cramping and pain throughout your levator ani muscles – remember that the pudendal nerves spread throughout those muscles. Even if you have no muscle cramping, since pudendal nerve entrapment often involves ligaments, the remedies below will also likely help you. Here are a number of techniques I’ve found work well in combination.
1. Apply a hot castor oil pack to rectal (levator ani) muscles. See instructions below.
2. Take a hot magnesium bath with Magnesium Oil added to your bathwater. Use 2 ounces of magnesium oil, or to save money, use 1 ounce of magnesium oil and 1 cup of Epsom salt.
3. Take atom-sized or angstrom magnesium – this allows you to ingest a lot more magnesium without causing diarrhea, or putting your rectal muscles into spasm because of the feedback loop mentioned above.
4. Take herbal muscle relaxants like crampbark and black haw.
5. Choose the best natural remedies for your type of constipation. ColonEaze~MOVE and Natural Calm magnesium citrate work well for most people.
6. Self administer a colonic massage to loosen the area and make bowel movements easier – see my video below. Also massage the levator ani muscles. If you feel your muscles from your sitz bones (the “sitting bones” you can feel at the bottom of your bum when you sit on a bicycle or hard seat), working up both sides of your buttocks and across just under your sacrum (the flat, slightly rounded pad of bone at the base of your spine) – you are feeling the levator ani muscles.
7. Have bodywork therapy by an osteopath or physiotherapist trained in Active Release Technique and/or Myofascial Release.
Hot Castor Oil Pack
A castor oil pack can be used anywhere on the body to relieve pain, cramping or spasming. I have used it repeatedly for many of my family and it has never failed to provide significant, and often total relief. But here I will give you specific directions for using it to relax your levator ani muscles – remember the pudendal nerve runs throughout the levator ani muscles.
If you feel your muscles from your sitz bones (the “sitting bones” you can feel at the bottom of your bum when you sit on a bicycle or hard seat), working up both sides of your buttocks and across just under your sacrum (the flat, slightly rounded pad of bone at the base of your spine) – you are feeling the levator ani muscles.
Materials Needed:
- Expeller-pressed castor oil
- White cotton flannel
- Hot water bottle or heating pad or heat dish
- Sheet of plastic (a garbage bag will work)
- Old t-shirt
- Old bath towel
Procedure:
Apply castor oil with your fingers directly to the levator ani muscles.
If you have a ceramic heat dish (I bought mine at Costco) the easiest way is just to kneel in front of the heat dish in “hemorrhoid position”. This means you are not on hands and knees, but on knees and elbows, so your butt is raised up in the air. Kneel as close to the heat dish as is comfortable for you and stay there for however long you can up to 30 minutes. Then it is best if you can get into a hot magnesium bath to absorb the magnesium transdermally and also wash off the excess castor oil. Otherwise, you can wipe it off, but unless it is completely removed it will stain your clothes or bedding.
If you do not have a heat dish, then you will need to lie down and use a hot water bottle or a heating pad as your heat source. In that case, apply the castor oil with your fingers to the levator ani muscles, then cover with the flannel cloth, then cover the cloth with the piece of plastic and apply the heat source (hot water bottle or heating pad).
Be sure and place the old bath towel underneath you to catch any drips and either wear an old t-shirt or go naked – since castor oil stains whatever material it comes in contact with.
You can either lie down on your back and have the heat source underneath you, or lie on your stomach and place the heat source on top of your bum. Use whichever feels best to you.
Relax for 30 to 60 minutes. This is an excellent time to practice visualization, meditation, or deep breathing exercises, listen to classical music or sleep – or to watch a good movie!
When finished, you can remove the oil with warm water and soap in the shower, or as I suggested, relax into a hot magnesium bath. Sometimes I prefer to just wipe the oil off with an old towel and then leave the oil residue on my skin to be completely absorbed while I sleep (I apply the pack at night, before bed – but I sleep on a towel or old sheets, as even the oil residue can stain).
Store the flannel in a large zip-lock bag. You can reuse it many times, replace the pack after it begins to change color (usually several months). Do not wash the flannel – just throw it out.
If you suspect you also have a rectal or anal stricture (build up of scar tissue), that would definitely be exacerbating your condition, or perhaps even be the sole cause of it. In that case, we have a very effective home remedy for that called Rectal StrictureHeal. We also have tried-and-tested remedies for internal and external hemorrhoids, and rectal and anal fissures. But if you’re pretty sure pudendal nerve entrapment is the cause of your chronic pelvic pain, then be sure and get my book with full instructions for treatment.
NOTE: This Home Remedy Page provides only basic information about natural treatment for pudendal nerve entrapment and pelvic pain. Check out my book, Jini’s Healing Guide: Rectal Spasm, Prolapse & Pain for complete, detailed instructions and dosages.