Neuropathic Pain

Burning, shooting, electric shocks, pins‑and‑needles, or pain from light touch point to nerve involvement, while cramping feels squeezing or throbbing. Symptoms may radiate along a line into the vulva, buttock, or leg, and sitting or tight clothes can worsen it. Mixed pain is common, so both nerve‑ and inflammation‑focused strategies may be needed.

Yes. Deep infiltrating disease can inflame or tether the pudendal, sciatic, obturator, or hypogastric nerves, causing cyclical sciatica‑like pain, genital burning, or rectal/vaginal shooting pain. If nerve contact is suspected, a team experienced in Deep Infiltrating Endometriosis can assess whether targeted excision may help alongside nerve‑focused care.

Repeated pain can sensitize the nervous system, making signals amplify and spread beyond the original site. Pelvic floor muscle guarding and cross‑talk between pelvic organs can perpetuate symptoms even when inflammation fluctuates. Addressing sensitization with pacing, sleep support, and rehabilitation—see Pelvic Floor PT and Stress Reduction—is often as important as treating lesions.

Clinicians look for neuropathic descriptors, map sensory changes, assess pelvic floor tone, and screen for nerve distribution patterns; imaging is reserved for specific concerns. Seek urgent care for new leg weakness, foot drop, saddle numbness, fever with severe back pain, or inability to pass urine or stool. For non‑urgent workup, targeted MRI or Ultrasound may complement exam findings.

Options can include SNRIs or TCAs, gabapentinoids, topical lidocaine, TENS, and nerve blocks such as pudendal or hypogastric injections; see Medical Management and Nerve Pain. Pelvic floor rehabilitation and desensitization techniques help reduce amplification, while surgical treatment is considered if a lesion is entrapping a nerve. Combining approaches often provides the best relief.