What Is Pudendal Neuralgia?

Pudendal neuralgia is pain experienced in the pelvic floor or external genitalia that is caused by microtrauma to the pudendal nerve.

Pudendal neuralgia is worse with sitting, and better with standing, laying down, or sitting on the toilet.

Why Do Some People Have Pudendal Neuralgia?

Trauma to the pudendal nerve most commonly can occur with childbirth, pelvic prolapse surgery, cycling, or excessive sitting.

If your pain has not resolved with decompression surgery or pelvic floor myofascial release, other causes of pudendal neuralgia include endometriosis, viral infections, venous congestion, diabetes, and autoimmune conditions.

How To Diagnose Pudendal Neuralgia

You will be diagnosed with pudendal neuralgia if all the following are true.

  • Pain in the area of the pudendal nerve
  • Pain primarily with sitting
  • Pain is not worse at night
  • No sensory loss
  • No itching with pain
  • Pain is not fleeting
  • Imaging doesn’t identify a different reason for pain
  • Pudendal nerve block relieves the pain

Biomedicine’s Approach to Pudendal Neuralgia

  • Pain killers and muscle relaxants
  • Myofascial pelvic floor therapy
  • Pudendal nerve block
  • Surgical decompression

My Holistic Approach to Pudendal Neuralgia

  • Set up the drainage system of the body
  • Optimize organ mobility (especially kidneys and uterus)
  • Address fascial constraint
  • Address ligamentous and joint imbalance
  • Optimize posture, breathing mechanisms, and postural muscle strength/activation

What to Expect

I will not be exclusively treating the pelvic floor

I will be identifying all the structures that have a bearing on the function of the pudendal nerve and optimizing their function.

If there is an underlying process like a viral infection, diabetes, or an autoimmune condition, we will treat that, too.

  • 20 hours of hands-on manual therapy
  • 2 hours of exercise
  • 1-4 hours internal medicine

I feel like patients get better faster if they get treatments close together in the beginning.

People usually do well with a minimum of 2 hours of care a week.

If you are coming in from out of town for care, we should be able to complete the care within 7-10 days.