056 - Dr Tracy Sher - Pudendal Neuralgia - What Health Professionals Really Need to Know to Provide Care and Hope

Yes it has been over 2 years since our last episode, but we’re back and full of excitement about the guests to come!

And what a great episode to kick off the re-boot. On this podcast we interview Dr Tracy Sher about all things related to Pudendal Neuralgia. Dr Sher is the Founder/CEO of the global platform, Pelvic Guru, LLC/Pelvic Global and the Global Pelvic Health Alliance Membership (GPHAM). She is also the Owner/Clinical Director of the private practice, Sher Pelvic Health and Healing in Orlando, Florida. 

In this podcast we cover:

• Pudendal neuralgia versus pudendal nerve entrapment. 
• Some basic anatomy including the pathway of the pudendal nerve and where it might become irritated or entrapped
• The “Pudendal Tour” - ie the challenging journeys that some patients will go on, including multiple scans, nerve conduction tests, injections and surgery.
• Some of the signs and symptoms that clients might present with
• What a physiotherapy assessment might look like and how to prioritise what to look at on day one
• The importance of a multidisciplinary team in the management of pudendal neuralgia and some of the specialties you might want to include in your team
• Some interesting case studies including patients who have been diagnosed with pudendal entrapment but there was something ELSE was going on…
• Acute onset pain that often gets missed (think post-surgical!)
• How we as health professionals need to be careful with our language (avoid nocebic language!) and can provide hope for these patients
• What might conservative Mx might look like for someone with pudendal neuralgia

Correction: Tracy wanted to add after the conversation:

“Numbness can end up being part of pudendal nerve entrapment. The Nantes criteria actually lists: “no objective sensory defects” but those who treat this clinically will see sensory changes. This was the original Nantes criteria - but we see many more nuances to this: pain limited to the territory of innervation of the pudendal nerve, pain predominant during sitting, pain does not awaken the patient from sleep, no objective sensory defects, a positive effect of anaesthetic infiltration of the pudendal nerve.The key is to do all differentials as it isn't a typical symptom. 

 I also stated S1-3 in the beginning and meant to say S2,3,4.”

As always, we felt like we could have picked Tracy’s brains for hours, so might have to get her to come back again in the future (or encourage her to come to Australia!).

You can reach Tracy at:
Website:  www.pelvicglobal.com  
Email: Tracy@pelvicguru.com
Instagram: @pelvicguru1
Twitter: pelvicguru1
Free Facebook Group: Pelvic Guru Academy