Pudendal neuralgia is a type of nerve pain that’s thought to impact around 1 in 100,000 people. However, some believe this number might be higher because not all healthcare providers are well-informed about the condition. Pelvic floor physical therapists, along with other medical specialists, play a crucial role in effectively treating pudendal neuralgia.
Did you know?
From 2002 to 2006, Liz Akincilar and Stephanie Prendergast, the cofounders of PHRC, dedicated their clinical careers to helping people recover from pudendal neuralgia. They noticed that most physical therapists lacked the necessary experience and training to treat this condition. In response, they created the first continuing education course on pudendal neuralgia for medical professionals in 2006. They have since taught this course to many individuals worldwide and frequently give lectures on the topic.
At PHRC, all of our physical therapists have been trained by Liz and Stephanie and are recognized as experts in pudendal neuralgia. We work closely with international specialists and surgeons specializing in PN to provide coordinated and effective care for patients who are suffering.
- The pain can be characterized as burning, shooting, stabbing, and/or lancinating.
- The pain is confined to the distribution of the pudendal nerve, affecting various areas of the pelvis supplied by the nerve. This includes the vagina, vulva, urethra, penis, scrotum, perineum, peri-anus, anus, and/or rectum.
- Pudendal neuralgia may lead to urinary dysfunction, manifesting as pain during urination (dysuria), increased urinary frequency, and/or urgent feelings to urinate.
- Bowel dysfunction is associated with pudendal neuralgia, resulting in pain during bowel movements or difficulties in evacuating stool.
- Sexual dysfunction is a common outcome of pudendal neuralgia, causing pain during arousal, intercourse, or genital stimulation. It can also contribute to challenges in achieving and/or maintaining an erection.
- Symptoms are often worsened by sitting, especially on a hard surface, and alleviated by sitting on a toilet or a cushion with a cut-out.
- Physical activity, such as deep squatting, climbing stairs, or walking up steep inclines, can exacerbate symptoms.
- Symptoms may persist constantly or occur intermittently.
- Pudendal Neuralgia symptoms tend to be minimal during sleeping and first thing in the morning but increase as the day progresses.
- The pain can be characterized as burning, shooting, stabbing, and/or lancinating.
- The pain is confined to the distribution of the pudendal nerve, affecting various areas of the pelvis supplied by the nerve. This includes the vagina, vulva, urethra, penis, scrotum, perineum, peri-anus, anus, and/or rectum.
- Pudendal neuralgia may lead to urinary dysfunction, manifesting as pain during urination (dysuria), increased urinary frequency, and/or urgent feelings to urinate.
- Bowel dysfunction is associated with pudendal neuralgia, resulting in pain during bowel movements or difficulties in evacuating stool.
- Sexual dysfunction is a common outcome of pudendal neuralgia, causing pain during arousal, intercourse, or genital stimulation. It can also contribute to challenges in achieving and/or maintaining an erection.
- Symptoms are often worsened by sitting, especially on a hard surface, and alleviated by sitting on a toilet or a cushion with a cut-out.
- Physical activity, such as deep squatting, climbing stairs, or walking up steep inclines, can exacerbate symptoms.
- Symptoms may persist constantly or occur intermittently.
- Pudendal Neuralgia symptoms tend to be minimal during sleeping and first thing in the morning but increase as the day progresses.
People often realize their symptoms when they find our website, blog, or social media. Some with a diagnosis lack a local pelvic floor physical therapist. Others with a therapist feel stuck or don’t see improvement. Some seek opinions from other trusted experts, and in uncertain times, some prefer not to leave their homes. Whatever your needs, we’re here and ready to assist!
Our team members specializing in pelvic floor disorders have additional areas of expertise. We are available to assist you, whether through in-person or virtual appointments. Please be aware that virtual visits require advance payment and are non-refundable. We are committed to providing you with the necessary support.
Get Relief from Pudendal Neuralgia
CONTACT USAssociated Diagnoses
- Myofascial Pelvic Pain Syndrome
- CPPS (Chronic Pelvic Pain Syndrome or Male Pelvic Pain Syndrome)
- Endometriosis
- Vestibulodynia
- Pudendal Nerve Entrapment
- “Cyclist’s Syndrome”
Pudendal Neuralgia Causes
- Chronic constipation
- Prolonged vaginal childbirth
- Activity related, such as long-distance cycling or heavy weight lifting that involves repetitive squatting
- Sitting for long periods of time for work, commuting, and/or school
- Surgical trauma, such as during pelvic organ prolapse surgical repairs that utilize mesh products
- Repetitive falls on your buttocks, such as with a snow sport
- Repetitive vaginal infections, such as bacterial vaginosis or vaginal candidiasis (yeast infection)
- Chronic pelvic floor hypertonus
Pudendal Neuralgia Causes
- Chronic constipation
- Prolonged vaginal childbirth
- Activity related, such as long-distance cycling or heavy weight lifting that involves repetitive squatting
- Sitting for long periods of time for work, commuting, and/or school
- Surgical trauma, such as during pelvic organ prolapse surgical repairs that utilize mesh products
- Repetitive falls on your buttocks, such as with a snow sport
- Repetitive vaginal infections, such as bacterial vaginosis or vaginal candidiasis (yeast infection)
- Chronic pelvic floor hypertonus
Diagnostic Challenges
Pudendal neuralgia is a lesser-known neuropathic pain condition that is not widely understood by medical providers. As a result, many healthcare professionals are unfamiliar with the diagnosis and may not feel confident in recommending treatment. Unfortunately, individuals who experience this type of pain often rely on online research and resources to self-diagnose. For instance, if someone experiences pain while sitting, they may jump to the conclusion that they have pudendal neuralgia based on what they read online.
Pelvic pain while sitting, nerve pain in the vagina, and nerve pain in the pelvis can be caused by various factors, and pudendal neuralgia may not be the only culprit. It’s important to note that there are multiple nerves associated with the pelvis, so not all nerve pain is directly linked to the pudendal nerve.
Another diagnostic challenge involves distinguishing pudendal neuralgia from the signs and symptoms of pudendal nerve entrapment. Pudendal nerve entrapment occurs when the nerve is restricted somewhere along its path within the pelvis. Unfortunately, accurately diagnosing pudendal nerve entrapment and its associated symptoms is currently impossible with existing medical technology. The only definitive method for diagnosing pudendal nerve entrapment is through a surgical decompression of the pudendal nerve. While not yet widespread, fortunately, an increasing number of medical specialists can now confidently diagnose pudendal neuralgia and offer valuable guidance for effective treatment.
Diagnostic Challenges
Pudendal neuralgia is a lesser-known neuropathic pain condition that is not widely understood by medical providers. As a result, many healthcare professionals are unfamiliar with the diagnosis and may not feel confident in recommending treatment. Unfortunately, individuals who experience this type of pain often rely on online research and resources to self-diagnose. For instance, if someone experiences pain while sitting, they may jump to the conclusion that they have pudendal neuralgia based on what they read online.
Pelvic pain while sitting, nerve pain in the vagina, and nerve pain in the pelvis can be caused by various factors, and pudendal neuralgia may not be the only culprit. It’s important to note that there are multiple nerves associated with the pelvis, so not all nerve pain is directly linked to the pudendal nerve.
Another diagnostic challenge involves distinguishing pudendal neuralgia from the signs and symptoms of pudendal nerve entrapment. Pudendal nerve entrapment occurs when the nerve is restricted somewhere along its path within the pelvis. Unfortunately, accurately diagnosing pudendal nerve entrapment and its associated symptoms is currently impossible with existing medical technology. The only definitive method for diagnosing pudendal nerve entrapment is through a surgical decompression of the pudendal nerve. While not yet widespread, fortunately, an increasing number of medical specialists can now confidently diagnose pudendal neuralgia and offer valuable guidance for effective treatment.
Pudendal Neuralgia Treatment: How We Can Help You
If you’re suffering from pelvic pain caused by pudendal neuralgia, seeking an evaluation with a specialized pelvic floor physical therapist can bring you relief. If you deem it more convenient, you can always try out their telehealth option or virtual services for initial consultation. During the evaluation, the therapist will go over your medical history, symptoms, previous diagnoses, and treatments you’ve tried, including their effectiveness. We understand the frustration you’ve been facing and are here to help.
In the physical examination, the therapist will assess your muscles, tissues, joints, nerves, and movement patterns. Afterwards, they will discuss their findings with you and provide an assessment that explains the development of pudendal neuralgia. They will create short and long-term treatment goals for you. Typically, physical therapy sessions are scheduled once or twice a week for about 12 weeks. You’ll also receive a home exercise program to complement the in-person sessions, and we’ll coordinate your recovery with the rest of your treatment team. Our goal is to help you recover and live your best life.
Want to learn more about our pudendal neuralgia treatment offerings?
Treatment:
Pudendal Neuralgia Treatment: How We Can Help You
If you’re suffering from pelvic pain caused by pudendal neuralgia, seeking an evaluation with a specialized pelvic floor physical therapist can bring you relief. If you deem it more convenient, you can always try out their telehealth option or virtual services for initial consultation. During the evaluation, the therapist will go over your medical history, symptoms, previous diagnoses, and treatments you’ve tried, including their effectiveness. We understand the frustration you’ve been facing and are here to help.
In the physical examination, the therapist will assess your muscles, tissues, joints, nerves, and movement patterns. Afterwards, they will discuss their findings with you and provide an assessment that explains the development of pudendal neuralgia. They will create short and long-term treatment goals for you. Typically, physical therapy sessions are scheduled once or twice a week for about 12 weeks. You’ll also receive a home exercise program to complement the in-person sessions, and we’ll coordinate your recovery with the rest of your treatment team. Our goal is to help you recover and live your best life.
Want to learn more about our pudendal neuralgia treatment offerings?
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At its heart, Pelvic Pain Explained is the story of how patients develop pelvic pain, the challenges patients and providers face throughout the diagnosis and treatment process, the difficult task of sifting through the different available treatment options, and the impact that an “invisible” condition has on a patient’s life and relationships, and much more.