Differential Diagnosis for Nerve Pain in Perineum
Single Most Likely Diagnosis
- Pudendal Neuralgia: This condition is characterized by chronic pain in the distribution of the pudendal nerve, which supplies the perineum. The pain is often described as burning, aching, or stabbing and can be exacerbated by sitting or certain activities.
Other Likely Diagnoses
- Coccydynia: Pain in the coccyx (tailbone) area can radiate to the perineum and be mistaken for nerve pain. It is often caused by trauma, such as a fall, or prolonged sitting.
- Levator Ani Syndrome: This condition involves pain and tenderness in the levator ani muscle, which is located in the pelvic floor. It can cause referred pain to the perineum.
- Prostatitis (in men) or Vulvodynia (in women): These conditions can cause chronic pain in the perineal area, which may be perceived as nerve pain.
Do Not Miss Diagnoses
- Cauda Equina Syndrome: A serious condition caused by compression of the cauda equina (nerve roots in the lower spine), which can lead to severe pain, numbness, and weakness in the legs, as well as bladder and bowel dysfunction. Prompt diagnosis and treatment are crucial to prevent permanent damage.
- Spinal Cord Injury or Compression: Trauma or conditions like spinal stenosis can cause compression of the spinal cord, leading to pain, numbness, and weakness in the perineum and legs.
- Malignancy: Certain types of cancer, such as prostate, rectal, or cervical cancer, can cause nerve pain in the perineum by invading or compressing nearby nerves.
Rare Diagnoses
- Tarlov Cysts: Rare, fluid-filled cysts that can form in the nerve roots of the spine, including those that supply the perineum, causing pain and numbness.
- Neurosyphilis: A rare complication of syphilis infection, which can cause nerve pain and damage, including in the perineum.
- Peripheral Neuropathy: Certain types of peripheral neuropathy, such as diabetic neuropathy or neuropathy caused by vitamin deficiencies, can affect the nerves in the perineum, leading to pain and numbness.