IG Live Q/A: Pudendal Neuralgia + Pudendal Nerve Entrapment

In pudendal neuralgia by Elizabeth AkincilarLeave a Comment

By Elizabeth Akincilar, MPT, Cofounder, PHRC Lexington


In May we went live on Instagram with Mark Conway, MD, gynecologist and pelvic surgeon specializing in pelvic neuralgias. We compiled a list of questions from social media to answer during our live about your inquiries about Pudendal Neuralgia. So what is Pudendal Neuralgia? It is a treatable pain condition that consists of stabbing, burning pain in the clitoris, penis, scrotum, perineum, urethra, and anus. The majority of people with pudendal neuralgia have pelvic floor dysfunction, peripheral nerve sensitivity, and dysregulation of the central nervous system.


We discussed:

  • Pudendal neuralgia and pudendal nerve entrapment
  • How to diagnose PN and PNE, what type of treatments are available and effective
  • Physical therapy, pudendal nerve blocks, pharmacotherapy and other helpful treatment strategies
  • How to diagnose pudendal nerve entrapment and who is a good candidate for pudendal nerve decompression surgery
  • Dr. Conways’ technique for pudendal nerve decompression surgery


Find the full video + a sneak peak below of some of the questions answered during the live!

For more educational videos by Elizabeth Akincilar & Dr. Conway, find them from Youtube at bottom of this blog!




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What exercises are recommended vs what are not recommended? Which activities and exercises exacerbate PN pain? 

pudendal neuralgia Do's pudendal neuralgia Don'ts

Do nerve blocks work? 

    1. The pudendal nerve itself is rarely the sole driver of the symptoms of PN, such as sitting pain. But rather, is one impairment of a myofascial syndrome composed of many parts. This is one reason why interventions directed at the nerve alone, such as nerve blocks, often provide limited or no relief.

How can the foam roller be used to do something good on the pelvic floor?

    1. External muscles and fascia surrounding the pelvic girdle have a relationship to the hip, buttock, back, groin and thigh pain (which are connected to the pelvic floor). Check out our videos on Youtube for foam rolling instructions!


Do you see any correlation with pudendal neuralgia and birth control? 

    1. Check out our blog archives about birth control


I had a nerve block in each cheek but did not see significant improvement but was numb. Couldn’t the nerve be trapped or pinched at any point on the PN and if missed wouldn’t help? 

    1. We have a blog that discusses the differences between PN and PN entrapment.


Sits bones and anus.. Could it be confused with ischial bursitis? 

    1. Patients with PN can have tingling, stabbing, and/or shooting pain anywhere in the territory of the nerve. Symptoms include vulvar or penile pain, perineal pain, anal pain, clitoral pain, and pain at the ischial tuberosities as well as pain with bowel movements, urination, and orgasm.


Additional Resources:

Pudendal Neuralgia Resource List

The Role of Physical Therapy in Treating Pudendal Neuralgia

How do I know if I have Pudendal Neuralgia or Pudendal Nerve Entrapment?


How to find informed medical providers:

International Pelvic Pain Society Find a Provider

American Physical Therapy Association’s Section on Women’s Health PT Locator

Herman and Wallace Find a Provider

Pelvic Guru Provider Directory


Are you unable to come see us in person? We offer virtual physical therapy appointments too!

Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online. 

Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page

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