Pudendal Neuralgia

May 7, 2025

Pelvic pain can be a distressing and often misunderstood condition, affecting both men and women. One lesser-known cause of chronic pelvic pain is pudendal neuralgia, a condition that occurs when the pudendal nerve, which supplies sensation and function to the pelvic area, becomes compressed or irritated. This can lead to debilitating symptoms that impact daily life, from sitting comfortably to engaging in intimate activities. Despite its significant impact, pudendal neuralgia is frequently underdiagnosed.

In this blog, we’ll explore what pudendal neuralgia is, its symptoms, potential causes, and how pelvic health physiotherapy can play a crucial role in managing and alleviating symptoms.

What is Pudendal Neuralgia?

Pudendal neuralgia is a chronic pain condition that results from irritation, compression, or damage to the pudendal nerve. This nerve runs from the lower back through the pelvic floor and is responsible for sensation and function in the genitals, perineum, and anus. When compressed or irritated, it can lead to persistent and often severe pain.

Common Symptoms of Pudendal Neuralgia

Symptoms of pudendal neuralgia can vary from person to person, but common signs include:

  • Burning, stabbing, or aching pain in the pelvic region
  • Pain that worsens when sitting and improves when standing or lying down
  • Numbness, tingling, or a “foreign object” sensation in the rectum or genitals
  • Pain during or after sexual activity
  • Bladder or bowel dysfunction, such as urgency, frequency, or difficulty emptying


These symptoms can be frustrating and debilitating, often leading to emotional distress, anxiety, and a decreased quality of life.


What Causes Pudendal Neuralgia?

There are several potential causes of pudendal neuralgia, including:

  • Prolonged sitting (especially on hard surfaces or during cycling)
  • Pelvic trauma or surgery that affects the nerve
  • Muscle tension or tightness in the pelvic floor
  • Childbirth injuries
  • Nerve entrapment or compression from scar tissue or inflammation
  • Medical conditions such as endometriosis or interstitial cystitis


Since pudendal neuralgia can have multiple contributing factors, proper diagnosis by a healthcare professional is essential for effective treatment.


How Can Pelvic Health Physiotherapy Help?

Pelvic health physiotherapy is a non-invasive and effective approach to managing pudendal neuralgia.

A trained pelvic health physiotherapist can assess your symptoms and develop a personalized treatment plan that may include:

  • Manual Therapy & Myofascial Release – Helps release muscle tension and improve blood flow to the affected area.
  • Pelvic Floor Relaxation Techniques – Since tight pelvic muscles can contribute to nerve irritation, learning how to properly relax these muscles is key.
  • Postural & Movement Retraining – Poor posture or movement patterns can put extra strain on the pudendal nerve. Physiotherapy can help correct these imbalances.
  • Nerve Mobilization & Desensitization Exercises – These gentle techniques help the nerve glide freely and reduce pain.
  • Lifestyle Modifications & Ergonomic Adjustments – Small changes like using a cushioned seat, avoiding prolonged sitting, and modifying certain activities can significantly reduce symptoms.


Seeking Help & Finding Relief

If you’re struggling with persistent pelvic pain, you’re not alone. Many people suffer in silence due to a lack of awareness and understanding about conditions like pudendal neuralgia. Fortunately, pelvic health physiotherapy can provide significant relief by addressing the root cause of pain and improving function.


Don’t let pelvic pain control your life. If you suspect you have pudendal neuralgia, consider consulting a pelvic health physiotherapist to explore treatment options tailored to your needs.


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