China
Africa
Explore chapters and articles related to this topic
Myofascial and Visceral Pain Syndromes: Visceral-Somatic Pain Representations
Published in Robert M. Bennett, The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, 2020
The urogenital [pelvic] floor is innervated by the sympathetic, parasympathetic, and somatic nervous systems. The sympathetic and parasympathetic [pelvic splanchnic nerve] nervous system input is through the inferior hypogastric plexus. Somatic innervation is through the sacral spinal cord. The pudendal nerve receives sympathetic fibers in addition to somatic nerves. It innervates the penis or clitoris, the anal canal, the urethral sphincter, and anterior perineal muscles. The posterior pelvic floor musculature is innervated by the coccygeal plexus. There is an overlap of pelvic splanchnic nerve and pudendal nerve afferent input in the spinal cord, such that stimulation of one area of the urogenital floor can influence the output to another area (32). Thus, persons with urogenital pain syndromes complain about bowel and bladder dysfunction, sexual dysfunction, and show increased pelvic floor muscle tone or develop pelvic floor TrPs, and a global dysfunction of the pelvic region is often seen clinically [IBS, IC, dyspareunia]. The urogenital pain syndromes that are commonly seen include vulvodynia [which is associated with a profound hyperalgesia as shown by the stabbing neuropathic-like pain associated with touching the vulva with a moist cotton swab], testicular pain [orchialgia], urethral syndrome [urgency, frequency, dysuria, and regional pain, similar to IC], and prost-atodynia [accounting for 30 percent of patients with prostatitis, often associated with pelvic floor muscle pain] (32).
Pelvis and perineum
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Coccygeal plexus– descending branch of S4, ventral primary rami of S5, coccygeal spinal n.– gives off cutaneous branches that innervate perineal skin ant. to coccyx
The Governor Vessel (GV)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Anococcygeal nerves from coccygeal plexus (S4, S5 and the coccygeal nerves): Provide cutaneous sensation to the coccygeal region. The coccygeal plexus forms within the ischiococcygeus muscle from the ventral rami of S4-Co1. It receives input from the sacral sympathetic trunk. The coccygeal plexus supplies the anococcygeal nerve that innervates subcutaneous tissue overlying the dorsal coccyx; some branches pass ventral to the coccyx.8 These nerves supply the skin of the anococcygeal region and likely contribute to the innervation of the coccygeal ligaments, periosteum, and the sacrospinous ligament and ischio-coccygeus muscle.
Influence of psychiatric disorders and chronic pain on the surgical outcome in the patient with chronic coccydynia: a single institution’s experience
Published in Neurological Research, 2020
Kristopher A. Lyon, Jason H. Huang, David Garrett
Given the strong association of psychiatric disorders in patients suffering from coccydynia, it is reasonable to consider a neuroanatomic reason that may relate these variables. Closely associated with the coccyx, the coccygeal plexus arises from the ventral primary rami of the S4, S5, and Co1 nerve roots along with contributions from the sacral sympathetic trunk [18]. The coccygeal plexus then goes on to give rise to nerves that innervate the sacrococcygeal joint, anococcygeal ligament, sacrotuberous ligament, and inconsistently, the coccygeus muscle [19]. Overactivity of these nerves may lead to increased tension or spasm of the muscles or tendons taking their origin off the coccyx. Therefore, as part of the pre-operative workup, many patients often seek physical therapy to include intra-rectal digital massage of the levator ani, coccygeus, and pyriformis muscles with or without nerve blocks using corticosteroids or local anesthetics injected into this region [20].