Pudendal Neuralgia and Chronic Pelvic Pain
What causes Pudendal Neuralgia and Chronic Pelvic Pain?
Pudendal Neuralgia
This condition is caused by irritation or compression of the pudendal nerve, which supplies sensation to the pelvic region. It can result from prolonged sitting, pelvic trauma, childbirth, surgery, or nerve entrapment. Left untreated, pudendal neuralgia can significantly impact daily activities and quality of life. Its most common symptoms are:
- Burning or stabbing pain in the perineum, genitals, or rectal area
- Numbness, tingling, or increased sensitivity in the pelvic region
- Pain while sitting
- Worsened symptoms with movement or activity
Chronic Pelvic Pain
Pelvic floor dysfunction can occur when the muscles of the pelvic floor become weak, tight or imbalanced. Pelvic pain may be derived from the pelvic floor muscles themselves, or as a result of nearby structural or functional issues including:
- Lumbar disc tears
- Sacral cysts
- Nerve entrapments from tight pelvic muscles or scar tissue
- Abdominal myofascial pain
- Sacral or pubic bone laxity / instability
- Hip labrum tears / impingement
Symptoms of Pudendal Neuralgia and Chronic Pelvic Pain
Common symptoms are:
- Heaviness or pressure in the pelvis, especially after physical activity or prolonged sitting
- A sensation that the bladder or bowel have not been completely emptied after urination or bowel movement
- Painful urination, increased urinary frequency, or painful sex
Diagnosing Pudendal Neuralgia and Chronic Pelvic Pain
There are many factors to consider when approaching chronic pelvic pain:
- Structural / physical—traumatic falls impacting the pelvis or low back, chronic gut issues, prior abdominal or pelvic surgeries, difficult pregnancy or labor, endometriosis, history of recurrent urinary tract infections, chronic constipation, hemorrhoids.
- Neurological—central mediated pain or central desensitization, peripheral nerve dysfunction.
- Psychosocial—chronic stress response, anxiety, depression, emotional or childhood traumas, poor communication or disharmony in a relationship.
It’s crucial to receive a comprehensive diagnostic work-up with imaging of the pelvis, lumbar spine, and hips, as indicated.
Nonsurgical Treatment for Pudendal Neuralgia and Chronic Pelvic Pain
Dr. Aufiero’s personalized approach and customized treatments plans are designed to engage the body’s natural healing processes, provide long-term relief, and enhance overall quality of life. She offers the following advanced nonsurgical interventions when addressing pelvic pain and pudendal neuralgia.
- Platelet-rich plasma (PRP) therapy including Platelet Lysate
- Nerve hydrodissection
- Extracorporeal shockwave therapy (ESWT)
- Biofeedback through modalities like Neufit
- Shockwave therapy, shown to help with reducing muscle spasms and tightness in the pelvic floor
- Therapeutic Botox and trigger point injections
- Treatment of concurrent lumbar or hip conditions that may be contributing to the pain
Recommendations and referrals may include:
- Lifestyle changes and stress reduction, including stellate ganglion block (SGB)
- Nutritional guidance and integration (referrals available)
- Pelvic floor physiotherapy referral
Visit Orthohealing Center Today!
If you’re navigating this transition and noticing changes in how your body moves or feels, we’re here to help with personalized care that respects your biology and your lifestyle. Book a consultation to receive an accurate diagnosis and learn how Orthohealing Center can support your healing journey, musculoskeletal health, sexual health, and overall well-being.
Related studies
- https://www.sciencedirect.com/science/article/pii/S2287888224000345
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9569307/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8780260/
- https://academic.oup.com/humrep/article/37/Supplement_1/deac105.062/6620133
- https://www.actualgyn.com/en/article/2024/301
- https://www.fertstert.org/article/S0015-0282(21)00747-0/fulltext
- https://www.sciencedirect.com/science/article/pii/S2287888224000345
- https://www.sciencedirect.com/science/article/pii/S1877065721000634