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Lifestyle changes for pudendal nerve neuropathy

Lifestyle changes for pudendal nerve neuropathy
Changing lifestyle with pudendal neuralgia

In any deterioration of health, changing one's usual lifestyle is assumed to alleviate the condition. However, unlike in the case of fractures or dislocations where you can eventually return to old habits and hobbies, dealing with pudendal neuropathy is a different story. Once the nerve is compressed or inflamed, it becomes necessary to care for it for the rest of your life to avoid further damage.

Many patients who undergo surgery to release the pudendal nerve eventually find relief from restrictions, but this isn't always the case. Regardless, considering a change in lifestyle is necessary immediately after the diagnosis of neuropathy. It happens that people suffering from pudendal neuralgia avoid complex and lengthy treatments, and even surgeries, simply by adjusting their habits.

Where to start?

The initial changes may be challenging, especially if the condition has been recently diagnosed, and you've had a habit of a certain type of activity for many years. Nevertheless, contemplating a lifestyle change is the first step because it can significantly improve your well-being.

People facing such a problem ask themselves the same questions:

- How can I continue working if I can't sit?

- How can I perform daily exercises considering my new condition?

- Should I completely give up all previous hobbies—such as cycling and motorcycling?

All newcomers are frightened when they realize the need to make so many new decisions, but with time, they find answers. Don't be too hard on yourself: it takes time to implement all these changes. If you notice yourself doing something you've decided not to do, such as sitting when you could stand, just make a mental note for the future.

Dietary changes

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Dietary restrictions are related to the need to prevent constipation, which is a common companion for patients with pudendal neuropathy. They should be avoided as much as possible. Since each person's body is individual, when facing such a delicate problem, the best solution is to consult with a nutritionist. They can help you create a menu that is both tasty and safe in this regard.

Another option is to use microclysters, laxatives, and similar remedies, but before starting to use them, you must consult a doctor.

A typical story at the appointment:

The patient is clearly on edge. The diagnosis was literally just made, and she is shocked, seemingly overwhelmed by all the manifestations of the disease at once. She has already read enough information about pudendal nerve compression and the restrictions she will have to live with, possibly for the rest of her life. But she hasn't read about ways to solve the difficulties yet:

— Doctor, I just don't understand what to do. I'll have to rebuild my entire life. I'm in pain. I'll have to give up fitness and yoga, stop leading an active lifestyle, and stay at home... well, no, I can't even sit at home! All these recommendations seem like mockery.

— Let's calm down a bit. I understand that accepting the diagnosis immediately is difficult, but many people lead a full life with it, and in some cases, surgery helps to eliminate all restrictions and radically get rid of the disease. I assure you, once you start figuring out what you can and can't do, you will feel better.

— Right now, it feels like I can't do anything. For example, I regularly went to fitness, and now any bend or attempt to squat is accompanied by excruciating pain.

— This happens with the tension of certain muscles, not all of them. We're talking about the muscles of the pelvic floor and those adjacent to them. Movement in this area needs to be restricted because it can lead to stretching of the nerve that hurts. But all other exercises are available to you, and giving up fitness is not necessary.

— I had to interrupt my session with the instructor because more than half of the exercises are simply painful to do. Or I know I can't do them.

Indeed, this can be discouraging at first. A patient accustomed to a certain rhythm of life is forced to abruptly change their habits, which may have been formed over years and without which they cannot imagine their existence.

— Instructors rarely encounter circumstances like yours. But you can set a task to find a set of exercises that you can do without harm. Primarily, these are any movements that only affect the upper half of the body.

— Okay... but what about the rest?

— It is necessary to exclude those exercises that are always detrimental to the nerve, such as bends and squats. But then there is some freedom of action. In many cases, the pain changes and may decrease depending on the body's position. Together with the trainer, you can try such a scheme: they show exercises that are not absolutely contraindicated, and you try to perform them. If you feel pain, stop immediately. This way, by process of elimination, you can find a complex that you can apply specifically to yourself.

— This probably will take a lot of time.

— I think just a few sessions. Don't strain yourself too much — the pain might be delayed, so try to be careful. But it's important that you modify your routine once — then it's just a matter of following it, which doesn't require much effort.

— But what would you recommend specifically that is definitely safe?

— Leg lifts from a standing position, back arches, leg abduction while lying on your side, and similar exercises — they relax the pudendal nerve and can temporarily alleviate pain. From strength training, you can focus on arms and back.

— What about abs?

— Very cautiously. Some of my patients do abdominal exercises, slightly modifying them and redistributing the load. You can try that too, with a trainer. And walking is absolutely fine for you — it can partially replace lower body exercises. You won't become a bodybuilder, but you'll maintain a nice figure.

— Is that all?

— Those are the basic principles. Pain is individual for each patient, so I would recommend getting help from a trainer. Together, you'll choose the movements that don't cause discomfort, and they as a specialist will balance the routine to be maximally beneficial. But the main condition is very simple: if it doesn't hurt, you can do it; if it hurts, you shouldn't.

— Doctor, this seems terribly complicated, and honestly, I feel like life is over and I've turned into a helpless invalid.

— That's normal. Any negative changes in lifestyle can provoke such feelings. You should consider seeing a therapist; I can recommend a specialist who deals with this issue. Acceptance of the diagnosis doesn't happen immediately; you need to go through all stages, including the stage of depression. But with a therapist, it's easier to do.

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What to Avoid with Pudendal Nerve Entrapment

This list is individual for each person, but there are some common recommendations. Every patient knows that with pudendal neuropathy, they should primarily avoid prolonged sitting and sports involving sitting. Particularly, this includes riding motorcycles, mopeds, and bicycles.

There are other, less obvious restrictions:

- Bends gradually stretch the nerve or its part (in case of entrapment) and can irreversibly damage it;

- Any exercises involving stretching the lower part of the body can cause multi-day neuropathic pain and require treatment.

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Refusing from cycling, yoga, and similar hobbies is often the toughest choice. Remember that you're doing it for yourself, not for others. Some patients have given up cycling, but there are those who haven't had to completely deprive themselves of their usual pleasures.

What You Can Safely Do with Pudendal Neuropathy

The main set of exercises approved for most patients undergoing treatment for pudendal neuralgia includes:

● Walking on flat surfaces (walking uphill and on rough terrain creates additional strain on the gluteal muscles, so it's not recommended);

● Swimming in any style except breaststroke, as it involves stretching the gluteal muscles during the "frog" motion;

● Any exercises developing the upper body, except those involving the abdominal muscles;

● Sliding exercises (especially after pudendal nerve decompression surgery).

Based on recommendations suitable for most patients, you can create your own set of rules that will help prevent additional damage to the entrapped nerve. Over time, you'll get used to them and follow them automatically. During experiments, especially regarding physical exercises and medications, consult with your treating physician.

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