By Stephanie Prendergast, MPT, Cofounder, PHRC Los Angeles
At PHRC we love anatomy! As physical therapists we have advanced training in the neuromuscular systems of our body. Knowing where things come from and where things go help make us expert diagnosticians and treatment providers!
Here is insight into which nerve roots are responsible for sensation in our pelvis. As you can see, the majority of sensation in our:
- genitals
- perineum
- bony pelvis
- upper thighs
comes from the lumbar and sacral spinal nerve roots!
As we help our patients understand their symptoms we sometimes ask them to mark their pain on diagrams like these. This information, combined with our physical examination, helps us better understand where the problem is coming from, what we can do as physical therapists to improve the impairments, and if additional medication intervention, such as nerve blocks, may be therapeutic.
We must know if we need to target a nerve root or peripheral nerve with various procedures to set our patients up for success. Deciding whether or not to undergo a procedure can be a big deal, we help our patients make informed decisions.
THIS‼️
Too often, all pain with sitting is called Pudendal Neuralgia. While the pudendal nerve is a big deal, many people with pelvic pain have pain at or outside of the ischial tuberosities. This is NOT pudendal neuralgia. Therefore, a pudendal nerve block will likely not be therapeutic. This diagram provides additional anatomic targets that can cause pain with sitting.
Many peripheral nerves can be associated with pelvic pain and pain with sitting. At PHRC, we evaluate all of these to best understand the pain our patients feel. We created these charts because we want to share our examination and assessment process.
Resources:
YouTube info
Cushion info to improve sitting comfort
Useful Websites
Pain Science education and treatment strategies: Tame the Beast
Pudendal Neuralgia Association
Self Treatment Tools
Cushions
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We are excited to announce our physical therapist, Molly, is now located in our 11th location in Columbus, OH. Now scheduling new patients- call (510) 922-9836 to book!
Are you unable to come see us in person in the Bay Area, Southern California or New England? We offer virtual physical therapy appointments too!
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
Melissa Patrick is a certified yoga instructor and meditation teacher and is also available virtually to help, for more information please visit our therapeutic yoga page.
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