Question
I have recently been diagnosed with pudendal neuralgia.

I am wondering if there could be a mechanical reason for this.

I do have a leg length difference - not sure if it's true or apparent

A chiropractor had told me I have a twisted pelvis that is causing a lot of torsion

I have a bulge at l5 s1 but no back pain.

I am wondering how much chiropractic adjustments could help relive pressure on this irritated pelvic nerve?

Answer
Dear Adrian Joseph O'Toole,

Thank you for your question regarding your reported neuralgia.  I just received notice today of it being posted, so I apologize for what is an apparent delay in responding.  

In order to answer you properly, I抣l first need to give you some background on anatomy and physiology and how they relate to the chiropractic profession.  

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.  Based on what limited information I have from you, it seems this is the type of chiropractic office you have visited.  

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  This is not the same as the matter of neuralgia or even leg differences or pelvic twisting, as you mention in your question, but they may exist together.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential, whatever that may be.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as exercise routines, posture, sleeping position and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, perhaps even alcohol, etc.), which are, unfortunately, typically uncontrollable and regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  For example, try specifically to "feel" your liver.  Try to be aware of exactly what it抯 doing right now.  You can't, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  For this reason alone, it is impossible for anyone to give you reliable answers as to a connection between the spine and specific symptoms of any kind, including the things you mention.  Certainly, every part of the body must have connections to the nerve system so that vital information may be transmitted between the brain and the cells.  There are some who would attempt to review the possible nerve connections between a nerve root and specific organs or tissues, but this ignores the multitude of variables that determine the expression of function.  The question of how your individual body carries out the myriad of activities just to maintain life is enormous and would require your Creator抯 (or creator抯, for the agnostic) knowledge, or at least far more than our educated knowledge of the complexities of life.

Now that you have more information about the body and vertebral subluxation, how do you make use of it?  Well, first understand that this is not an explanation of why you may have pain / neuralgia symptoms or whether any of it may be related to vertebral subluxation.  Are there reasons for what you抮e experiencing?  Even though they may be beyond our ability to identify, yes, there are; but pinning them down is not relevant to the matter of whether you will benefit from being free of vertebral subluxations.  It is not valid or reliable to try to connect it to pain or any other organ or tissue conditions.  The only way to know if someone has a vertebral subluxation is to have that person抯 spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.  The term for this procedure is 揳djustment.?br>
Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential!

A key question to ask for your purposes, then, would be, Is someone with neuralgia better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  It抯 not that you should see a non-therapeutic straight chiropractor FOR your neuralgia ?you should visit one in an effort to be free of vertebral subluxations, even WITH such a complaint.  Non-therapeutic straight chiropractic is not about diagnosing and/or treating neuralgia or any therapeutic-model or medical condition.  It is entirely separate in its goal.  Neuralgia is not the reason for attending to the vertebral subluxations.  In fact, those who understand the effects of vertebral subluxations choose to have their spines checked regularly and on an ongoing basis independent of symptoms.  This is the best recommendation that anyone can give you regarding vertebral subluxations.  I have no reason to tell you otherwise.  

That said, it would, indeed, be wise to have your spine checked by a non-therapeutic straight chiropractor - even if you still elect to have therapeutic attention or advice for your reported symptoms.  Visiting a non-therapeutic straight chiropractic office is for a different, larger purpose.  It is the only way to know if vertebral subluxations are present and interfering with your potential.  As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What I can tell you must not be interpreted from the mixed viewpoint.  

If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or at [email protected].  You may also visit www.gschiro.com, a site that represents non-therapeutic straight chiropractic organizations on a state level.

Adrian, I wish you the best in understanding what non-therapeutic straight chiropractic has to offer.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.