EFFECTIVENESS OF EGOSCUE EXERCISES WITH TENS AND CONVENTIONAL THERAPY WITH TENS IN WOMEN WITH PUDENDAL NEURALGIA
DOI:
https://doi.org/10.67034/2786-8354.2026.20.2.05Keywords:
Pudendal Nerve Entrapments, Pelvic Pains, Postures, Transcutaneous electrical nerve stimulation, pelvic floor muscle strength, Quality of lifeAbstract
Introduction. This study was focused on comparing the effectiveness of Egoscue exercises with TENS and Conventional therapy with TENS to reduce pain, enhance the strength of pelvic floor muscle and Quality of life in patients with pudendal neuralgia.
Materials and Methods. A randomized controlled trial, single blinded study was carried out involving 30 women between 40–55 years were diagnosed with Pudendal neuralgia. Participants were randomly allotted into two treatment groups: Group A underwent Egoscue exercises with Transcutaneous Electrical Nerve Stimulation, and Group B received conventional therapy with Transcutaneous Electrical Nerve Stimulation. Both interventions were administered four times per week for six weeks. Outcome measures included pelvic floor muscle strength (MizCure Perineometer), pain intensity (Numerical Pain Rating Scale), and quality of life (NIH-CPSI), assessed at pre-intervention and post-intervention.
Results. After the six-week intervention, both groups showed statistically significant improvements. Pain intensity measured by NPRS decreased in Group A from 7.6 (IQR: 7.5-7.8) to 2.8 (IQR: 2.7-2.9) p < 0.001, compared to a smaller reduction in Group B from 7.5 (IQR: 7.45-7.6) to 5.5 (IQR: 5.45-5.6) p < 0.001. Pelvic floor muscle strength assessed using the MizCure perineometer showed greater improvement in Group A 18.3 (IQR: 18.2-18.45) mmHg to 33.4 (IQR: 33.15-33.95) mmHg, p < 0.001 than in Group B 18.4 (IQR: 18.25-18.60) mmHg to 24.0 (IQR: 23.8-24.2) mmHg, p < 0.001. Improvements in quality of life measured by NIH-CPSI were also superior in Group A 35.6 (IQR 35.1-35.9) to 20.8 (IQR 20.3-21.3), p < 0.001 compared to Group B 35.5 (IQR 35.0-35.8) to 28.0 (IQR 27.8-28.6), p < 0.001. Between group analyses confirmed significantly greater post intervention effects in Group A across all primary outcomes (p < 0.001), indicating a clinically meaningful advantage of Egoscue based intervention.
Conclusions. Compared to conventional physiotherapy using TENS and Egoscue exercises with TENS was more efficient in pain relieving, increasing the strength of pelvic floor muscle, and the quality of life in women with the pudendal nerve.
References
1. Abe-Takahashi, Y., Kitta, T., Ouchi, M., Okayauchi, M., Chiba, H., Higuchi, M., Togo, M., & Shinohara, N. (2020). Reliability and validity of pelvic floor muscle strength assessment using the MizCure perineometer. BMC Women’s Health, 20(1), 257. https://doi.org/10.1186/s12905-020-01127-x
2. Augustina, S. J., Suganthirababu, P., Rajagopal, V., Kumaresan, A., Srinivasan, V., Ramana, K., Kamalakannan, M., Alagesan, J., & Prathap, L. (2023). Pelvic floor dysfunction and its impact on quality of life among female health care employees. Work, 74(3), 1055–1059. https://doi.org/10.3233/WOR-211125
3. Berghmans, B. (2018). Physiotherapy for pelvic pain and female sexual dysfunction: An untapped resource. International Urogynecology Journal, 29(5), 631–638. https://doi.org/10.1007/s00192-017-3536-8
4. Conic, R. R. Z., Kaur, P., & Kohan, L. R. (2025). Pudendal neuralgia: A review of the current literature. Current Pain and Headache Reports, 29(1), 38. https://doi.org/10.1007/s11916-024-01354-z
5. Eid, M. M., Rawash, M. F., Sharaf, M. A., & Eladl, H. M. (2021). Effectiveness of transcutaneous electrical nerve stimulation as an adjunct to selected physical therapy exercise program on male patients with pudendal neuralgia. Clinical Rehabilitation, 35(8), 1142–1150. https://doi.org/10.1177/0269215521995338
6. Fawaz, R., Ltaief-Boudrigua, A., & Duraffourg, M. (2024). Pudendal nerve entrapment syndrome: Clinical features, diagnosis, and management. Pain Medicine. 26(1), 39–42. https://doi.org/10.1093/pm/pnae092
7. Finnerup, N. B., Kuner, R., & Jensen, T. S. (2021). Neuropathic pain: From mechanisms to treatment. Physiological Reviews, 101(1), 259–301. https://doi.org/10.1152/physrev.00045.2019
8. Galán, J. P., Rodríguez, Á. R., Bravo, R. S., Millán, V. G., & Ruiz, M. G.-B. (2024). Indoor cycling and pudendal entrapment neuropathy. The Journal of Sexual Medicine, 21(Suppl. 4). qdae041.071. https://doi.org/10.1093/jsxmed/qdae041.071
9. Giulioni, C., Pitoni, L., Fuligni, D., Beltrami, M., Passarella, V., Palantrani, V., De Stefano, V., Castellani, D., & Galosi, A. B. (2024). Pudendal nerve neurolysis outcomes. Investigative and Clinical Urology, 65(3), 230. https://doi.org/10.4111/icu.20230402
10. Jensen, M. P., Turner, J. A., Romano, J. M., & Fisher, L. D. (1999). Comparative reliability and validity of chronic pain intensity measures. Pain, 83(2), 157–162. https://doi.org/10.1016/S0304-3959(99)00101-3
11. Khoder, W., & Hale, D. (2014). Pudendal neuralgia. Obstetrics and Gynecology Clinics of North America, 41(3), 443–452. https://doi.org/10.1016/j.ogc.2014.04.002
12. Kovacevic, N., Sirls, L., Gilleran, J., & Peters, K. (2023). Peripheral nerve stimulation for pudendal neuralgia. Frontiers in Urology, 3:1323444. https://doi.org/10.3389/fruro.2023.1323444
13. Kudchadkar, G., Gurudut, P., & Welling, A. (2019). Comparative effect of mat pilates and Egoscue exercises. Indian Journal of Physical Therapy and Research, 1(2), 79. https://doi.org/10.4103/ijptr.ijptr_38_19
14. Levesque, A., Bautrant, E., Quistrebert, V., et al. (2022). Recommendations on the management of pudendal nerve entrapment syndrome. European Journal of Pain, 26(1), 7–17. https://doi.org/10.1002/ejp.1861
15. Liang, W., Wu, Z., Zhang, G., Chen, W., Hu, X., Yang, J., Meng, J., Zeng, Y., Li, H., & Shang, X. (2020). A urine-based biomarker for chronic prostatitis/chronic pelvic pain syndrome: A retrospective multicenter study. Translational Andrology and Urology, 9(5), 2218–2226. https://doi.org/10.21037/tau-20-1268
16. Memon, H. U., & Handa, V. L. (2013). Vaginal childbirth and pelvic floor disorders. Women’s Health, 9(3), 265–277. https://doi.org/10.2217/WHE.13.17
17. Piñeiro-Franco, L., Alonso-Calvete, A., & Da Cuña-Carrera, I. (2024). Management of pudendal neuralgia with electrical stimulation: A systematic review. Actas Urológicas Españolas (English Edition), 48(6), 416–426. https://doi.org/10.1016/j.acuroe.2024.02.001
18. Ramalingam, V., Cheong, S. K., & Lee, P. F. (2023). Effect of six-week short-duration deep breathing on young adults with chronic ankle instability: A pilot randomized controlled trial. BMC Sports Science, Medicine and Rehabilitation, 15(1), 155. https://doi.org/10.1186/s13102-023-00758-5
19. Ranjan, R., Chanda, C., Kushwaha, R., & Nag, A. R. (2022). Anatomical study of the variants of extrapelvic part of the pudendal nerve. Cureus, 14(8): e28281. https://doi.org/10.7759/cureus.28281
20. Robert, R., Labat, J.-J., Riant, T., Louppe, J.-M., & Hamel, O. (2009). Le nerf pudendal: Morphogenèse, anatomie, physiopathologie, clinique et thérapeutique. Neurochirurgie, 55(4–5), 463–469. https://doi.org/10.1016/j.neuchi.2009.07.004
21. Saranya, P., Thenmozhi, M. P., & Dhasaradharaman, K. (2023). Comparative effect of Egoscue exercises. International Journal of Health Sciences and Research, 13(6), 225–259. https://doi.org/10.52403/ijhsr.20230641
22. Suganthirababu, P., Parveen, A., Mohan Krishna, P., Sivaram, B., Kumaresan, A., Srinivasan, V., Vishnuram, S., Alagesan, J., & Prathap, L. (2023). Prevalence of work-related musculoskeletal disorders among health care professionals: A systematic review. Work, 74(2), 455–467. https://doi.org/10.3233/WOR-211041
23. Thangasheela G, J., R., V., M., M., Saju Mk, F., A., A., Navamani J, M. A., Krishnan, M., & Babu, S. (2023). Different types of Corrective exercises on Correction of Hyper Lumbarlordosis in Females – A Narrative Review. Journal of Advanced Zoology, 44(S-3), 1359–1368. https://doi.org/10.17762/jaz.v44iS-3.1663
24. Vallinga, M. S., Spoelstra, S. K., Hemel, I. L. M., Van De Wiel, H. B. M., & Weijmar Schultz, W. C. M. (2015). Transcutaneous electrical nerve stimulation as an additional treatment for women suffering from therapy-resistant provoked vestibulodynia: A feasibility study. The Journal of Sexual Medicine, 12(1), 228–237. https://doi.org/10.1111/jsm.12740
25. Zapletal, J., Nanka, O., Halaska, M. J., Maxova, K., Hajkova Hympanova, L., Krofta, L., & Rob, L. (2024). Anatomy of the pudendal nerve in clinically important areas: A pictorial essay and narrative review. Surgical and Radiologic Anatomy, 46(2), 211–222. https://doi.org/10.1007/s00276-023-03285-7
26. Clemens, J. Q., Calhoun, E. A., Litwin, M. S., McNaughton-Collins, M., Kusek, J. W., Crowley, E. M., & Landis, J. R. (2009). Validation of a Modified National Institutes of Health Chronic Prostatitis Symptom Index to Assess Genitourinary Pain in Both Men and Women. Urology, 74(5), 983-987.e3. https://doi.org/10.1016/j.urology.2009.06.078
