Tinel's four signs for functional diagnosis of pudendal nerve compressive syndromes

Abstract

Background: Pudendal nerve entrapment is a prevalent condition, physically and emotionally limiting. Due to myofascial origins, there is an important role for pelvic physiotherapy, but kinesiological-functional tests are still needed. Aims: To propose palpatory tests for the location, differentiation and qualification of the severity of different pudendal nerve entrapments. Method: Integrative review on Pubmed, LILACS, PEDro and Scielo databases, seeking the anatomical and functional bases of pudendal compression syndromes. Results: More than a thousand papers returned from the searches, of which 106 survived the inclusion and exclusion criteria. Precise anatomical descriptions of the pudendal nerve pathways and the main sites of possible entrapment were found. From there, four specific irritative tests could be proposed. Conclusion: There are anatomical and functional bases for four pudendal irritative nerve compression tests at four levels to provide functional tools for the assessment and treatment of compressive neuralgias of this nerve. For historical and technical reasons these should be known as The Tinel signs for the Pudendal Nerve.