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Pelvic Pain Support Network
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Pudental Neuralgia

Prior to having a Spinal Cord Stimulator implanted I had another lumbar MRI. I knew from an earlier MRI I had a bulging L5S1 disc This MRI showed the L5S1 disc had ruptured.

I have read on line this can lead to Caudal Equina Syndrome as well as cause compression of Pudental nerve via the Piriformis muscle. None of the three Orthopedic Drs I've seen ever mentioned the disc causing problems with the Pudental nerve

Has anyone had disc problems with resulting Pudental Neuralgia? Rocky68

17 Replies

Hi, I just read your post. I have been looking for other people with PN and what, if they know, could have caused the onset of this. I have been to every doctor on the planet, it feels like, with no concrete answers. The Mayo Clinic was my last best hope, and after going on a seven hour journey round trip twelve times in ten months, they couldn't do anything else. The pain clinic wanted to set me up for a three week pain management program, but I couldn't afford it.

Where in your back are these discs located? Bless your heart. You are not alone. I looked to find out who, within this community, lives close. You are about 170 miles from me. I live close to Georgia Southern University or about an hour from Savannah. If you live around this region, we could possibly share doctor info regarding who I have been to and so on.


My Pain Dr is with the Neurosurgery and Spine Clinic in Greensboro. I'm not sure we are allowed to post Dr names on this site

The Dr who removed my coccyx is in Charlotte but I do not recommend him

I heard from Orthopedic Dr today that she was not knowledgeable on PN to know if ruptured L5S1 is causing Periformis muscle to compress Pudental nerve. No referrals offered by her

I have call into Pain Dr asking him this question and will post answer if given one. The L5S1 disc is at end of spine. Rocky68

1 like

I don't know if I sent you response to questions about medical facilities I've visited. I don't think we are supposed to give names on this site but I will give the practices.

The only real support was with my Pain Management Dr with Carolina Neurosurgery and Spine in Greensboro. While he has not cured me he has me on medications which help. He has also suggested the Spinal Cord Simulator. He is compassionate and listens to my concerns.

My coccyx was removed in Charlotte, NC. I will not recommend that facility.

I visited two other Orthopedic Drs 1) Greensboro Orthopedics. Received several injections by them and on last one Dr said (live with it). (2) visited female Orthopedic Dr with Murphy Wainer who gave me diagnosis but offered no additional help

I had Gynocologist visit as well as sigmoidoscopy and prolapse scan by Eagle Medical Practice in Greensboro

I have found no Dr who gave me definitive diagnosis and only hope Spinal Cord Simulator helps. Rocky68


I just posted review of DRG Stimulator trial. Rocky68


I had Microdiscectomy for L5S1 and developed scar tissue. Had 2 great years post surgery and now have had chronic perineal pain and spasms for two years. What kind of stim are you getting? I had Axium DRG worked great on surrounding muscle and nerve pain, but at S2 level it did not cover rectal pain.


I actually contacted my Pain Management Dr to ask him to look at what I was told was a ruptured L5S1 disc. He personally called Thursday afternoon and said he looked at my MRI and the disc was not ruptured but there was a a tiny bubble bulging from disc. He said there was no nerve that should be affected by this disc.

He says he is going to use a Dorsal Root Stimulator but did not give me name of SCS.

I have psyche evaluation 10/17 for insurance purposes. I am making appt Monday to have a detailed discussion with Pain Management Dr about procedure.

Did your SCS stop spasms and burning around perineum and did it stop back pain? I'm disappointed to hear it did not help rectal problem. I have unbelievable rectal pressure when I lay down. It feels like I need to go to bathroom.

Overall are you glad you had SCS implant? I'll post what my Dr tells me. Thank you for writing. Rocky68


Met with Pain Dr today. He is using Proclaim Dorsal Root Stimulator. Two leads at S1 and two leads at S3. I'm waiting for trial date. I'll keep you updated. Rockt68


I did not have the implant. Even though I had relief from low back, SI joint, groin, hip and leg pain, they were all secondary to the purpose of the trial which was for and rectal pain. The trial stimulation did not adequately relieve that pain. The Leads were at L1S2. The doctor offered to place leads at S3 if I decided to have surgical implant. I decided that it was too risky without another trial. I am leaning towards a trial using sacral stimulation using Interstim.


I will need to ask my Dr about the sacral nerve interstim option. When you talk about rectal pain is it pressure as though you need to go to bathroom or actual pain?



I had psyche evaluation yesterday and Dr asked if I had tried Cymbalta which I haven't. Have you used it and did it offer relief? I should know Tuesday where Dr is putting leads. Rocky68


When is your trial for DRG?


Hi Shelall. It was scheduled for this Friday 11/17 but Drs office called me yesterday saying he needed to postpone procedure due to family emergency until 12/1. Needless to say I'm not too happy but Dec 1. Will be here soon. I had to go to Surgery Center today to have EKG and.bloodwork done. I guess he plans to give me anesthesia. I'll post as soon as Trial has begun. Stay in touch. Rocky68


Shelall. I began DRG Trial yesterday. I have received relief from back pain but still have spasms at rectum. Rep is going to increase current tomorrow. Have you had the Interstim Trial yet? Rocky68


Where are your leads for rectal area?. Mine were at S2. I completed the trial for Interstim. I had a lead at S4 on Left and at S3 on right. I went ahead with the implant surgery on Friday right side only. Two remotes and two stimulators seemed to be too much and too confusing. I can sit better and the spasms are better, but the stimulation is more intense than DRG. If only the DRG reached my worst area of pain, it would have be great because I had a lot of other relief in hip, SI joint and groin area. I hope they can adjust things for you. I will let you know how I progress. Hoping for the very best for you!


It's good to hear from you. My leads are at S1 and S3. I have pretty bad bruising. I have four leads. I could not sit except upright due to bruising. Was getting discouraged last night as spasms (more like nerve endings going off below rectum) and I thought DRG wasn't going to work. Called my contact and she had me increase levels to 46. She said the longer I have Stimulator the better since I've had this condition for seven years and my nervous system has to readjust. My back hasn't hurt but it never did unless I drove any distance or did strenuous chores. I'm at a loss whether to do implant or perhaps ask for ten day rather than seven day trial. I'm supposed to call Rep tomorrow afternoon and let her know how I'm doing. I hope to take short drive to see if I can sit without feeling like I'm sitting on a rock. Will stay in touch. Rocky68


My trial for DRG was 7 days. My trial for Interstim was 14 days. I think the first couple of days Of both trials were a mix of getting to use to the device and getting past the post op procedure. If you can trial for 10 days I think that may give you a more accurate read on how much the stimulation helps you. I know it is hard to stay calm, but try as best you can and rely on your rep to guide you.


I have actual rectal pain and spasms. I have a lot of tailbone and glute pain. I can't stand for too long or else I have a lot of pressure and burning in my entire pelvic carriage. My diagnosis is levator ani syndrome.


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