Understanding Pudendal Neuralgia: How Pelvic PT Can Help Relieve the Pain
Pelvic pain can feel mysterious, frustrating, and isolating—especially when it’s sharp, burning, or shooting and no one can quite figure out why. If you’ve been told you might have pudendal neuralgia, you’re not alone. While it’s often misunderstood or misdiagnosed, pelvic floor physical therapy can play a key role in managing and healing this condition.
Let’s break it down: what pudendal neuralgia is, what it feels like, and how pelvic PT can help.
What Is Pudendal Neuralgia?
Pudendal neuralgia is chronic pain related to the pudendal nerve, which runs from the lower spine through the pelvis and provides sensation to the genitals, anus, and perineum (the area between the genitals and anus). It also serves the important role of innervating the pelvic floor muscles so they can contract.
This nerve can become irritated, compressed, or entrapped due to:
- Prolonged sitting or cycling
- Childbirth or pelvic trauma
- Surgery or scar tissue
- Chronic constipation or straining
- Tight pelvic floor muscles or posture imbalances
- Tight piriformis or compression in the deep posterior hip
When irritated, the pudendal nerve can send false pain signals, even when there’s no obvious injury.
What Does Pudendal Neuralgia Feel Like?
Symptoms vary from person to person but may include:
- Burning, stabbing, or shooting pain in the vagina, penis, anus, or perineum
- Pain that worsens when sitting, especially on hard surfaces
- A sensation of “something stuck” or a foreign object in the rectum or vagina
- Numbness or hypersensitivity in the pelvic region
- Sexual dysfunction or pain with intimacy
- Urinary urgency, frequency, or discomfort
Many people with pudendal neuralgia go from doctor to doctor trying to find an answer. But once nerve involvement is suspected, specialized care—like pelvic floor PT—becomes essential.
How Can Pelvic PT Help?
While medications or injections may offer temporary relief, pelvic floor physical therapy addresses the root cause: muscle tension, nerve irritation, movement patterns, and posture contributing to the pain.
Here’s how I help:
1. Muscle Release and Relaxation
Tight pelvic floor muscles or surrounding hip muscles can compress the pudendal nerve. I use gentle, targeted manual therapy techniques—internally and externally—to release tension and restore normal muscle tone.
2. Nerve Mobilization Techniques
With specific movements and gentle stretches, I can help the pudendal nerve glide more freely, reducing irritation and improving nerve function.
3. Postural and Movement Education
Poor sitting posture or hip mechanics can add stress to the nerve. I’ll teach you body mechanics, sitting positions, and daily habits that protect and support your healing.
4. Breathwork and Nervous System Regulation
Chronic pain sensitizes the nervous system. Learning to engage the diaphragm and calm the body through breath can reduce overall tension and improve outcomes.
5. Personalized Home Exercises
I’ll guide you through gentle stretches, nerve glides, and relaxation techniques tailored to your needs and phase of healing.
You Are Not Broken. And You Are Not Alone.
Pudendal neuralgia can make everyday life feel overwhelming—sitting, working, driving, intimacy, even using the bathroom can become a source of anxiety. But there is hope.
Pelvic floor physical therapy gives you a safe, evidence-based path forward. With time, consistency, and compassionate care, it is absolutely possible to reduce pain, regain function, and reclaim your life.
Ready to Start Healing?
If you suspect pudendal neuralgia or are experiencing unexplained pelvic pain, let’s talk. At Hidden Strength PT, I specialize in helping people make sense of their symptoms and find relief.
✨ Your body is trying to protect you. Let’s help it feel safe again.
Contact me to schedule a consultation or learn more about how I can help.
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