Pelvic Pain May Be due To Pelvic Nerve Dysfunction: The Nerves of the Pelvis Get Pushed and Squished In these Conditions

Pelvic pain may be due to a variety of causes, but sometimes an infrequently thought of diagnosis is that of what I might term pelvic nerve disease. Nerve based pain can occur in almost any part of the body. Typically it can be from an injury: such as a back pain. It is one of those conditions that some gynos have discovered to be a less common cause, but important none the least. Pain is produced because a woman will have a heightened nerve signal feedback due to damage or disease of one or more of the affected nerves which is a condition called neuropathy. Pelvic nerve neruropathy is most often due to nerve based pain in either or both of the the two largest pelvic nerves: the pudenal and the perineal nerves. The pain, or neuropathy, is secondary to either stretch and compression. A more rare cause of pudenal or perinal neuropathis,  could be genetic tendency to getting nerve inflammation. The causes may have been compression from a pregnant uterus, nerve compression or stretch around a fibroid or cysts, damage from a surgery, aging of the nerves, or just idiopathic (no specific cause). Aging does a number of things to our nerve function or signals, just an abnormal number of signals coming from the affected nerves can cause pelvic floor neruopathy. This may not cause pain, it may just manifest as poor muscular control. In the pelvic this can cause weak bladders, or problems with bowel movements or feeling less pleasure with sex. Aging also reduces the number of functional nerves we have. For instance: at age twenty we have about a 1: 2 ratio of nerve to muscle fibers, and by 50 we have 1:5 and by age 70 we have 1:10, so just aging we get progressive neuropathies. In the situation where a pelvic mass (like a cyst or a fibroid) causes compression on a nerve, then the the flow in blood vessels around the nerve decreases. If the compression is too severe the flow stops. After a few hours of no blood flow the is a clot that forms in a particular blood vessel and the clot leads to complete death of that blood vessel that is not reversible. The pressures in these blood vessels is actually fairly high. The labor contraction force is about 60 to 100 mm HG pressure and in the pushing stage can be 240 mm of pressure and there is no blood flow through your pelvic floor pudendal vessel at about 80 mm of HG! Stretching causes nerve damage as well. Greater than a 20% stretch causes nerve damage, and just to give you an idea of what this might mean: women stretch our pudental nerves about 30% in the pushing phase of labor. Long labor pushing stages, chronic coughing and constipation cause stretching on pelvic floor nerves.


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