Individualized multimodal pain management for chronic perineal pain: A case report.
Xuemeng Ren, Lixin Cong
✦ AI-curated · Sources linked
Case in brief
A 68-year-old woman had three years of chronic perineal pain and tenderness that disrupted sleep, urination, and daily activities. Clinical assessment, examination, and comprehensive evaluation suggested neuropathic involvement of the pudendal nerve and lumbosacral or sacral nerve roots. Management combined oral pregabalin, CT-guided sacral canal catheterization with targeted nerve-root adhesiolysis and ozone injection, pain monitoring, psychological support, pelvic floor training, and individualized rehabilitation. At two weeks, her pain score fell from 8/10 to 3/10 and no longer disturbed sleep. Pain later rose temporarily to 5/10, then stabilized at 4/10 at one month while she continued pregabalin.
Diagnostic / clinical pearl
Persistent perineal pain may involve neuropathic contributions from the pudendal nerve and lumbosacral or sacral roots; assessment should integrate clinical manifestations and examination findings.
Why it matters
The case illustrates that symptom improvement may fluctuate, supporting continued pain assessment and individualized rehabilitation alongside multimodal management.