What Is Pudendal Neuralgia? Signs, Causes & Treatment Options
Strange Pelvic Pain? It Might Be Pudendal Neuralgia.
If you’re living with:
- Burning sensations in the pelvis or perineum
- Numbness or altered feeling in the groin
- Sharp shooting pains down below
- Discomfort when sitting, cycling, or walking…
And tests keep coming back “normal” — you’re not imagining it.
You might have Pudendal Neuralgia.
Let’s break down what it is — and why there’s real hope for recovery.
What Is Pudendal Neuralgia?
Pudendal Neuralgia is irritation, compression, or dysfunction of the pudendal nerve — the major nerve supplying the:
- Genitals
- Perineum (the area between anus and genitals)
- Pelvic floor muscles
When this nerve gets irritated or trapped, it can trigger a confusing mix of pain, numbness, and hypersensitivity.
Common Symptoms
✅ Burning or electric pain in the pelvis, groin, buttocks, or genitals
✅ Numbness or altered sensation in the saddle region (where you sit)
✅ Pain worse with sitting, improved when standing or lying
✅ Increased urinary urgency or frequency (sometimes)
✅ Pain during or after intimacy
✅ Pain when cycling or sitting for long periods
Common Causes of Pudendal Neuralgia
🔹 Injury or Trauma:
- Cycling accidents
- Falls onto the pelvis or buttocks
- Surgical complications (especially pelvic, hip, or spinal surgeries)
🔹 Repetitive Strain:
- Long-distance cycling
- Prolonged sitting (e.g., office work, driving)
🔹 Postural Issues:
- Pelvic tilt or asymmetry
- Core weakness and poor spinal-pelvic control
🔹 Chronic Pelvic Floor Tension:
- Overactive pelvic muscles putting pressure on the nerve
🔹 Rarely, Tumors or Inflammatory Conditions
(But serious causes are rare and usually ruled out early.)
💬 Real Patient Story: Dan, 37
“It started with a weird numbness after a long bike ride. Then came the burning. I went to three different doctors before anyone mentioned the pudendal nerve.”
“Finding the right help — and real answers — changed everything.”
Why It’s Often Misdiagnosed
Pudendal Neuralgia symptoms can mimic:
- Sciatica
- Prostatitis
- Chronic pelvic pain syndrome (CPPS)
- Hernias
Because scans often appear normal, patients are sometimes:
- Told it’s “all in their head”
- Misdiagnosed with psychological conditions
- Left untreated for months or even years
How We Diagnose at Male Health Clinic
✅ Thorough history taking (injury, posture, activity)
✅ Symptom mapping (nerve-specific areas)
✅ Movement and posture assessments
✅ Selective nerve tension and sensitivity tests
How Pudendal Neuralgia Is Treated
The great news?
Surgery is rarely needed.
✅ Pelvic Floor Muscle Retraining:
Release chronic tension trapping the nerve.
✅ Shockwave Therapy (Focused):
Reduce inflammation, stimulate nerve healing, soften fibrosis.
✅ Postural and Mobility Rehab:
Correct pelvic tilt, improve glute/core control, relieve compression points.
✅ Nervous System Regulation:
Calm hypersensitive nerve pathways and reduce flare-ups
✅ When to Seek Help
You should book an assessment if:
- Pain has lasted more than 3–4 weeks
- Sitting consistently worsens symptoms
- Numbness, burning, or stabbing feelings are present
- Previous treatment for “sciatica” or “pelvic pain” hasn’t helped
