Sacral nerves and their branches innervate the vulva. An injury to the spine, a tumor, or a cyst also could cause vulvodynia. Vulvodynia could conceivably be caused by a virus, but we have not been able to isolate any specific virus. Some cases of vulvar pain are related to herpes viruses. These viruses live on the dorsal root ganglion, and periodically migrate to the skin and form painful vesicles.
Some women develop a postherpetic syndrome.
These women are treated with acyclovir to prevent or minimize outbreaks. Pure VVS is rare. Vulvodynia, on the other hand, literally means chronic vulvar pain. VVS is one category of vulvodynia. Ideally, the tricyclic antidepressants will block the nerve conduction of most of the pain impulses.