Osteopathy frequently relieves the suffering of the pudendal nerve and the pathology of Alcock’s canal
Interest of osteopathy in the suffering of pudendal nerve or Acock’s canal
1 to 2% of the french population suffer from pudendal nerve. The pudendal nerve is derived from the sacral plexus S2 S3. Its enters the gluteal region under the piriformis muscle, ... and then wins the pelvis through the small opening provided by the decomposition of envelope of the internal obturator. The terminal branches of this nerve are destined to the rectum, anus, skin of the abdomen, muscles of the perineum, the dorsum of the penis and the clitoris.
Suffering of this nerve can cause symptoms in these anatomical areas !
The nerve may be trapped in two locations :
the piriformis muscle,
the lower pelvic area at Alcock’s canal where the nerve is pressed in the decomposition of envelope of the internal obturator.
The nerve may also suffer in the aftermath of pelvic fractures, during prolonged sitting, after some difficult deliveries or postoperative pelvic floor ...
The subject experiences pain in perineum sitting worse and supine calming. The pain may radiate forward or backward. Burning sensation, numbness.
Difficulties in ejaculation, in defecation or in sexual intercourse may exist ...
The neurological examination is normal.
At rectal examination, there is a sharp pain in relation to the ischial spine and sometimes pain in the levator ani.
The electromyogram of the pudendal nerve is strong evidence to support the clinics.
The usual treatment of pudendal neuralgia involves the use of anti-depressants or infiltration or even surgical decompression of the pudendal nerve in the Alcock’s canal.
Osteopathy treats the suffering of the pudendal nerve as follows :
. osteopath relaxes many muscles of the pelvis and perineum which trap the pudendal nerve,
. osteopath frees some trapped joints of the lower back, sacrum and the hinge between the sacrum and coccyx
. osteopath kneads the tissue around the pudendal nerve to make them more flexible and less adherent to the pudendal nerve.
In my personal experience, these osteopathic techniques give good to very good results and should absolutely be tried. Only in the event of failure of osteopathy and medicine, it must, in my opinion, be made a series of infiltration of the pudendal nerve. The latter also have an effect that is often transient.
Dr. Gilles Mondoloni, osteopathic physician (France,West Paris region), attached teaching hospitals of Paris, a specialist in pudendal nerve and Alcock’s canal)
For more information on osteopathy, read : "be treated by osteopathy, Dr. Gilles Mondoloni, Odile Jacob, 2006.