Pudendal Neuralgia Featured


What is Pudendal Neuralgia?



Pudendal Neuralgia

The pudendal nerve is a major nerve (like the sciatic nerve) arising from the sacral plexus.  It is an important nerve for differential diagnosis in cases of CPP (Chronic pelvic pain). The difference between pain arising from somatic structures (muscle, bladder, bowel etc) are that they are often achey or deep.  Nerve pain is different and will behave in a manner where manifestations of lancinating, sharp, throbbing or stabbing sensations are experienced. This is what we call neuropathic pain.  Pain is often felt along the pathway of the nerve.

The location of pain can be widespread in the pelvis but is often felt in the soft bit of the saddle region (between the rectum and genitals).

Pain can develop because or tension or stretching in the saddle region.  More common for women through child birth.  Sometimes heavy exercise can bring on symptoms. The more robust structures in the pelvis makes this less of an issue in men but cyclists can develop pain in this region.  There is emerging evidence that prolonged sitting or cycling could be a contributing factor due to the compression element.  Therefore, awareness of sitting times is a key component in the management of pain. Less common for men is the direct trauma due to surgery unless local to the rectum and sometimes this can be the case, although rare, with prostate treatments.  General increase in tension through the pelvis due to recurrent infection could cause muscle tightness impacting on fascia and therefore tensioning across the nerve.  Such instances may include prostatitis or, less common, interstitial cystitis.  




  • Hands on manual therapy treatment to your low back and pelvis, getting the joints moving correctly

  • Trigger point therapy: Getting the muscles working properly and getting rid of the overactive parts in both the low back muscles, hip muscles and pelvic floor muscles. You will also be taught how to do this yourself.



  • Pelvic floor exercises to release your pelvic floor

  • Specific hip, spine and pelvis exercises to get you and your pelvic floor moving better, think yoga poses and squatting

  • Specialised Breathing and relaxation work

  • Re-education of the  pelvic floor, hip and abdominal musculature

  • Gluteal exercises to get the BIG hip muscles moving and strong - this is so important and often a component left out of a rehab program.

Other management strategies can include the use of local Injection to anaesthetise the nerve.  This should always be used in conjunction with conservative therapies. 


Both Abarna (Female and Male pelvic floor) and Adrian (Male pelvic floor) treat this condition with clinics taking place at Tilehurst and the Sports Park

Last modified onThursday, 10 August 2017 17:10
Adrian Wagstaff

Adrian is the Lead clinican at Core Body Clinic.  He is a well known and experienced physiotherapist who qualified in 2001 from the University of Huddersfield with a BSc (Hons) in Physiotherapy.

Website: www.corebodyclinic.co.uk
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