Pudendal Nerve Block: Targeted Relief for Pelvic, Perineal, Rectal, and Genital Nerve Pain

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A pudendal nerve block is an image-guided injection placed near the pudendal nerve, a major pelvic nerve that can contribute to pain in the perineum, rectal region, anus, genital region, pelvic floor, and sitting area.

Pudendal nerve blocks are often discussed for suspected pudendal neuralgia, pudendal nerve entrapment, chronic pelvic nerve pain, perineal pain, rectal-region nerve pain, genital-region nerve pain, and pain that worsens with sitting.

At SpinePain Solutions, our pudendal nerve block technique is not transvaginal. We use an image-guided approach designed for pelvic nerve pain evaluation in both male and female patients. The procedure is performed from outside the body using imaging guidance, not through the vagina.

This distinction matters. Pudendal neuralgia is not only a female pelvic pain condition. Men may experience pudendal nerve pain involving the perineum, penis, scrotal region, rectal region, sitting bones, pelvic floor, or cycling-related pain. Women may experience pain involving the perineum, vulvar or clitoral region, labial region, rectal region, pelvic floor, or sitting area.

A pudendal nerve block may be diagnostic, therapeutic, or both. If numbing the pudendal nerve temporarily relieves the familiar pain, the block may help confirm that the nerve is involved. If medication around the nerve reduces irritation or inflammation, relief may last longer than the numbing medicine itself.

Important: Pelvic Pain Has Many Possible Causes

Pelvic, perineal, rectal, genital-region, urinary, bowel, or sitting pain can come from many sources. Possible causes include pudendal nerve irritation, pelvic floor dysfunction, prostate conditions, gynecologic conditions, urologic conditions, colorectal disease, hip disease, sacroiliac joint pain, lumbar spine problems, infection, vascular causes, and post-surgical pain.

A pudendal nerve block is most appropriate when the pain pattern, history, examination, imaging when needed, and prior workup suggest that the pudendal nerve may be part of the problem.

Quick Answer: What Is a Pudendal Nerve Block?

It is an injection near the pudendal nerve. This nerve may contribute to pelvic, perineal, rectal, anal, genital-region, or sitting pain.
It may help selected male and female patients. Pudendal neuralgia can affect men and women.
Our technique is not transvaginal. The block is performed from outside the body using imaging guidance.
It can be diagnostic. Temporary relief after numbing the nerve may help confirm the pain pathway.
It can be therapeutic. Medication around the nerve may reduce irritation or inflammation in some patients.
It is not for every pelvic pain condition. Urologic, gynecologic, colorectal, prostate, hip, spine, pelvic floor, vascular, and infectious causes may need evaluation.
The next step depends on the response. Options may include pelvic floor therapy, medication adjustment, repeat block, pulsed radiofrequency, peripheral nerve stimulation, or specialist referral in selected cases.

Table of Contents

What Is the Pudendal Nerve?

The pudendal nerve arises from the sacral nerve roots and travels through the pelvis toward the perineum. It provides sensation and motor supply to important pelvic floor, genital, rectal, and perineal structures.

The pudendal nerve travels near the sacrospinous and sacrotuberous ligaments and then courses through the pudendal canal, also called Alcock canal. Along the way, it divides into several branches, including branches that supply the rectal region, perineum, and external genitalia.

Because of this anatomy, pudendal nerve irritation may cause pain in several different regions, including:

Perineum
Rectal or anal region
Pelvic floor
Penis, scrotal region, vulvar region, labial region, or clitoral region
Sitting bones or deep buttock region
Area between the genitals and anus

The pudendal nerve overlaps clinically with pelvic floor muscle pain, sacral nerve root irritation, sacroiliac joint pain, hip pain, prostate pain, gynecologic pain, colorectal pain, and other pelvic nerve pathways. This is why diagnosis can feel like a maze with too many doors.

Pudendal Pain Is Often a Sitting Pain Problem

Classic pudendal neuralgia often worsens with sitting and may improve when standing, lying down, or sitting on a toilet seat. This pattern is not universal, but it is an important clue.

Symptoms That May Suggest Pudendal Neuralgia

Pudendal neuralgia refers to pain caused by irritation, compression, inflammation, entrapment, or injury of the pudendal nerve.

Symptoms may include:

Burning, shooting, stabbing, electric, raw, foreign-body, or pressure-like pain in the pelvic or perineal region
Pain worsened by sitting
Pain improved by standing, lying down, or sitting on a toilet seat in some patients
Rectal, anal, perineal, genital-region, penile, scrotal, vulvar, labial, or clitoral pain
Numbness, tingling, hypersensitivity, or altered sensation in the pudendal nerve region
Pain after pelvic surgery, childbirth trauma, cycling, falls, prolonged sitting, or pelvic injury
Pain with bowel movements, urination, sexual activity, or pelvic floor contraction in some patients
Pelvic floor spasm or deep pelvic muscle tenderness

These symptoms can overlap with pelvic floor dysfunction, prostatitis, vulvodynia, endometriosis, interstitial cystitis, colorectal disorders, SI joint pain, hip pain, lumbar or sacral nerve root irritation, cluneal nerve pain, and other pelvic nerve conditions. A careful evaluation is essential before deciding that the pudendal nerve is the main pain generator.

The Block Helps Answer a Question

The key question is not simply “Do you have pelvic pain?” The better question is: “Is the pudendal nerve carrying this pain signal?” A targeted pudendal nerve block can help answer that question.

What Can Irritate the Pudendal Nerve?

The pudendal nerve can become painful after compression, stretch, inflammation, trauma, surgery, prolonged mechanical irritation, or entrapment along its pelvic course.

Possible contributors include:

Prolonged sitting or cycling-related pressure
Pelvic trauma, falls, or direct injury
Childbirth-related pelvic injury
Pelvic surgery or scar tissue
Pelvic floor muscle spasm or obturator internus spasm
Compression near the sacrospinous or sacrotuberous ligaments
Irritation in or near Alcock canal
Post-surgical pelvic nerve irritation
Inflammatory pelvic conditions
Sacral nerve root irritation
Unknown causes, which can occur even after detailed workup

Who May Benefit From a Pudendal Nerve Block?

A pudendal nerve block may be reasonable when the pain pattern fits the pudendal nerve pathway and the result would help guide treatment.

Patients Who May Be Better Candidates

Patients with pelvic, perineal, rectal, anal, or genital-region nerve pain
Patients whose pain worsens with sitting
Patients with burning, shooting, electric, stabbing, raw, or hypersensitive pain in a pudendal distribution
Male patients with penile, scrotal, perineal, rectal, or sitting pain when pudendal neuralgia is suspected
Female patients with vulvar, labial, clitoral, perineal, rectal, or sitting pain when pudendal neuralgia is suspected
Patients with suspected pudendal nerve entrapment or irritation
Patients with persistent pelvic pain despite pelvic floor therapy, medication, or conservative care
Patients who need diagnostic clarification before considering a longer-term nerve pain plan

Who May Not Be a Good Candidate?

This block may not be appropriate when the pain pattern does not fit the pudendal nerve pathway or when another diagnosis needs urgent or more specific evaluation.

Patients Who May Not Be Good Candidates

Patients with new, severe, unexplained pelvic, abdominal, genital, rectal, or testicular pain needing urgent evaluation
Patients with suspected infection, abscess, acute abdominal process, torsion, cancer-related emergency, or severe colorectal disease
Patients with uncontrolled bleeding risk or unsafe anticoagulation status
Patients with active infection near the injection site
Patients with widespread pelvic pain where one nerve block is unlikely to explain the main problem
Patients with severe hip, spine, urologic, gynecologic, or colorectal disease clearly explaining symptoms
Patients expecting one injection to permanently cure all pelvic pain

Pelvic Pain Red Flags Need Prompt Evaluation

New severe pelvic, abdominal, rectal, genital, or testicular pain
Fever, chills, drainage, or signs of infection
Blood in urine or stool
New bowel or bladder incontinence
New leg weakness, saddle numbness, or neurologic changes
Severe pain after trauma
Pregnancy-related pelvic or abdominal pain
Rapidly worsening or unexplained symptoms

Our Pudendal Nerve Block Technique

Our pudendal nerve block technique is not transvaginal. It is an image-guided approach performed from outside the body. This makes the procedure applicable to both male and female patients when the clinical picture supports pudendal nerve involvement.

The technique is based on a posterior image-guided approach to the pudendal nerve region near the ischial spine and pudendal neurovascular bundle. The patient is typically positioned prone, meaning lying face down. Imaging is used to identify the bony pelvic landmarks and guide needle placement toward the target region.

The goal is to place medication near the pudendal nerve pathway, commonly near the region where the nerve travels close to the ischial spine and toward Alcock canal. A small amount of contrast may be used when appropriate to confirm spread before medication is injected.

This approach is different from older landmark-based or transvaginal techniques. It is designed for precision, diagnostic clarity, and broader use in both men and women.

Not a Transvaginal Procedure

Our pudendal nerve block is performed using an external image-guided approach. It does not require vaginal access and may be considered in appropriately selected male and female patients.

What Happens During a Pudendal Nerve Block?

A pudendal nerve block is usually performed as an outpatient procedure. The exact details depend on patient anatomy, symptoms, medical history, and physician judgment.

Step 1: Evaluation and Target Selection

The physician reviews the pain location, sitting sensitivity, pelvic symptoms, surgical history, trauma history, prior imaging, pelvic floor therapy response, medication history, and possible competing diagnoses. The goal is to decide whether the pudendal nerve is a likely pain pathway.

Step 2: Positioning

The patient is usually positioned face down. The skin over the pelvic target region is cleaned carefully in a sterile manner.

Step 3: Image-Guided Needle Placement

Fluoroscopy or another image-guided method is used to identify pelvic landmarks such as the ischial spine. The needle is advanced toward the pudendal nerve target region using image guidance. The target is selected to improve the chance of reaching the pudendal nerve pathway while avoiding nearby structures.

Step 4: Contrast Confirmation

When appropriate, contrast dye may be used under live imaging to help confirm needle position and medication spread before the therapeutic medication is injected.

Step 5: Medication Injection

The medication may include local anesthetic, steroid, or another medication depending on the purpose of the block and the patient’s condition. Local anesthetic may temporarily numb the painful nerve pathway.

Step 6: Response and Follow-Up

The patient should track how much relief occurred, how long it lasted, whether sitting tolerance improved, and whether the usual pain triggers changed. This information helps guide the next step.

Track Sitting Pain Carefully

If the familiar sitting-related pelvic, perineal, rectal, or genital-region pain improves while the nerve is numb, that response can be diagnostically meaningful, even if the pain later returns.

Why Image Guidance Matters

The pudendal nerve is deep in the pelvis and travels near important blood vessels, ligaments, muscles, and pelvic structures. The anatomy is not a casual surface injection. Image guidance helps the physician identify bony landmarks, guide needle depth, and confirm the intended target region.

Image guidance may help the physician:

Identify the ischial spine and surrounding pelvic landmarks
Approach the pudendal nerve target region without transvaginal access
Adjust for patient-specific anatomy
Reduce the chance of testing the wrong pathway
Use contrast when appropriate to confirm medication spread
Improve confidence that the block result is meaningful

Even with careful image guidance, a block is not perfect. Pelvic pain may involve pelvic floor muscles, sacral nerve roots, hip disease, SI joint pain, prostate conditions, gynecologic conditions, colorectal disease, urinary conditions, or other pelvic nerves.

Pelvic Nerve Anatomy Is Deep and Complex

The pudendal nerve is not a simple skin-level target. Image guidance helps, but diagnosis still depends on the pain map, sitting pattern, examination, imaging when appropriate, and response to the block.

How Long Does Relief Last?

Relief after a pudendal nerve block varies. Some patients feel relief only while the local anesthetic is active. Others may improve for days, weeks, or longer if nerve irritation or inflammation decreases.

The duration of relief depends on several factors:

Whether the pudendal nerve is truly the main pain generator
Whether the correct target region was reached
Whether steroid or another medication was used
Whether the nerve remains mechanically irritated by sitting, pelvic floor spasm, scar tissue, cycling, trauma, or entrapment
Whether other pain generators are present, such as pelvic floor dysfunction, sacral nerve root irritation, SI joint pain, hip disease, colorectal disease, prostate conditions, urologic conditions, or gynecologic conditions

A short but strong response can be diagnostically meaningful. Longer relief may be therapeutic. No relief may suggest that the diagnosis, target, or pain generator needs to be reconsidered.

What If the Pudendal Nerve Block Helps?

If a pudendal nerve block helps, the result may suggest that the pudendal nerve is part of the pain pathway. The next step depends on how much relief occurred, how long it lasted, and whether sitting tolerance or the familiar pelvic pain pattern improved.

Possible next steps may include:

Observation if relief is strong and lasting
Pelvic floor physical therapy or restarting therapy once pain is quieter
Medication adjustment for nerve pain
Activity modification, sitting modifications, or cycling avoidance when relevant
Repeat pudendal nerve block in selected cases
A second confirmatory block when diagnostic certainty is needed
Pulsed radiofrequency treatment in selected cases
Peripheral nerve stimulation in selected chronic refractory cases
Referral to urology, gynecology, colorectal surgery, pelvic floor specialists, or another specialist when overlapping conditions remain possible

Relief Gives Direction

A helpful pudendal nerve block does not always mean the pudendal nerve is the only pain source. But it can show that the nerve is important enough to guide the next step.

What If the Block Does Not Help?

If the block does not help, that information can still be useful. It may mean the pudendal nerve is not the main pain generator, the target was not reached well enough, the pain is coming from another structure, or the problem involves more than one pathway.

When the block does not help, the plan may shift toward:

Rechecking the pain map and sitting pattern
Reviewing pelvic or lumbar imaging when appropriate
Considering pelvic floor dysfunction or obturator internus spasm
Considering sacral nerve root irritation or spine-related pain
Considering SI joint, hip, cluneal nerve, genitofemoral nerve, or ilioinguinal nerve involvement
Considering urologic, gynecologic, prostate, colorectal, or abdominal causes
Trying a different targeted diagnostic block if clinically appropriate

A Negative Block Is Still Information

If the familiar pelvic, perineal, rectal, genital-region, or sitting pain does not improve after a properly performed block, the diagnosis may need to move beyond the pudendal nerve.

Pudendal Neuralgia vs. Other Pelvic Pain Conditions

Pudendal neuralgia can look like many other pelvic pain conditions. A pudendal nerve block targets one nerve pathway, but not every pelvic pain pattern comes from the pudendal nerve.

Possible Pain Source	Common Clues	Possible Treatment Direction
Pudendal Nerve Pain	Perineal, rectal, genital-region, or sitting pain; often worse with sitting	Pudendal nerve block, pelvic floor therapy, nerve medication, pulsed RF, PNS in selected cases
Pelvic Floor Dysfunction	Muscle spasm, pain with pelvic floor contraction, dyspareunia, bowel or urinary symptoms	Pelvic floor physical therapy, muscle-directed treatment, coordinated specialist care
Urologic or Prostate Conditions	Urinary urgency, frequency, burning, prostate-region symptoms, infection-type symptoms	Urology evaluation and condition-specific treatment
Gynecologic Conditions	Cycle-related pain, deep pelvic pain, vulvar pain, endometriosis-type symptoms, reproductive organ symptoms	Gynecology evaluation and condition-specific treatment
Colorectal or Anal Conditions	Bleeding, bowel changes, rectal pressure, anal pain, fissure or hemorrhoid-type symptoms	Colorectal evaluation and condition-specific treatment
Spine, SI Joint, Hip, or Other Nerve Pain	Back, buttock, hip, leg, sacral, groin, or referred pain patterns	Spine, hip, SI joint, cluneal, genitofemoral, or other targeted evaluation

Pudendal Nerve Pain in Male and Female Patients

Pudendal neuralgia can affect both male and female patients. The nerve anatomy is shared, but the pain description may differ depending on which branches are involved and how the symptoms are experienced.

In Male Patients, Symptoms May Include:

Penile pain
Scrotal-region pain
Perineal pain
Rectal or anal-region pain
Pain with sitting
Pain after cycling, pelvic trauma, prostate procedures, or pelvic surgery

In Female Patients, Symptoms May Include:

Vulvar pain
Labial or clitoral-region pain
Perineal pain
Rectal or anal-region pain
Pain with sitting
Pain after childbirth trauma, pelvic surgery, or pelvic floor dysfunction

In both men and women, pudendal nerve pain may overlap with pelvic floor muscle spasm, urinary symptoms, bowel symptoms, sexual pain, hip pain, sacral pain, or spine-related pain.

Risks and Side Effects

Pudendal nerve blocks can be helpful in selected patients, but they are still medical procedures. Risks depend on the target, medication, patient anatomy, medical history, and whether image guidance is used.

Possible Side Effects and Risks Include:

Temporary soreness at the injection site
Bruising or bleeding
Temporary numbness, warmth, heaviness, or altered sensation in the pelvic, perineal, rectal, or genital-region area
Temporary increase in pain
Infection, uncommon but possible
Nerve irritation or nerve injury, uncommon but possible
Allergic reaction to medication, uncommon but possible
Local anesthetic side effects
Vascular injury or hematoma
Temporary leg numbness or weakness if medication spreads to nearby nerves
Temporary bowel or bladder changes, uncommon but important
Failure to improve

Patients taking blood thinners or patients with bleeding disorders, infection, medication allergies, prior complex pelvic surgery, or significant medical conditions should discuss risks carefully before the procedure.

Low Risk Does Not Mean No Risk

A pudendal nerve block should have a clear purpose: to test or treat a suspected pudendal nerve pain pathway. The safest injection is one that answers a useful clinical question.

Recovery After the Block

Most patients go home the same day after a pudendal nerve block. Some may notice temporary numbness, warmth, heaviness, or pain relief in the pelvic, perineal, rectal, or genital-region area if local anesthetic is used.

Patients should be careful during the numb period. If sitting feels easier immediately after the block, that does not mean the underlying tissue or nerve is ready for prolonged sitting, cycling, heavy lifting, or aggressive activity right away.

General Recovery Tips

Track pain relief during the first few hours after the block.
Notice whether sitting tolerance improves.
Notice whether the usual pelvic, perineal, rectal, or genital-region pain changes.
Avoid heavy lifting, prolonged sitting, cycling, or aggressive pelvic activity immediately after the procedure unless instructed otherwise.
Be cautious if the leg feels temporarily weak, numb, or heavy.
Follow medication and activity instructions provided by the physician.
Call the office if symptoms are severe, worsening, or unusual.

If the block is diagnostic, the early response is especially important. Patients should write down how much relief occurred, how long it lasted, and whether usual triggers such as sitting, pelvic floor contraction, walking, bowel movement, urination, or sexual activity changed.

Do Not Waste the Diagnostic Window

If the block is meant to help diagnose the pain source, the first few hours matter. Track whether the usual sitting-related pelvic, perineal, rectal, or genital-region pain improves while the nerve is numb.

How to Prepare for the Procedure

Preparation depends on the patient’s medical history, medications, planned technique, and whether sedation is used. Most blocks are outpatient procedures, but patients should still follow instructions carefully.

Before the Procedure

Tell the physician about blood thinners, aspirin, anti-inflammatory medications, and supplements.
Report any infection, fever, antibiotic use, or recent illness.
Tell the physician about medication allergies, contrast allergy, latex allergy, or prior reaction to injections.
Tell the physician about prior pelvic surgery, childbirth trauma, prostate procedures, colorectal surgery, gynecologic surgery, cycling injury, pelvic trauma, or pelvic floor therapy.
Bring or review relevant imaging if available.
Ask whether you need a driver, especially if sedation is planned.
Ask what symptoms to track after the injection.

Cost, Insurance, and Coverage

Insurance coverage for a pudendal nerve block depends on the diagnosis, payer policy, documentation, medical necessity, medication used, image guidance, and whether prior authorization is required.

Some plans may cover pudendal nerve blocks for selected diagnoses when medically necessary. Others may require additional documentation or may limit repeat procedures.

Patients should ask:

Is the pudendal nerve block covered by my insurance?
Is prior authorization required?
What diagnosis is being used?
Is the block diagnostic, therapeutic, or both?
Will fluoroscopic guidance be used?
Will contrast be used?
Will sedation be used?
What are my out-of-pocket costs?
What happens if the block helps?
What happens if it does not help?

For treatments that are not covered or are self-pay, our office can discuss payment options. For eligible patients, CareCredit financing may be available depending on approval and available terms.

Questions to Ask Before a Pudendal Nerve Block

Before the block, patients should understand what pain pathway is being tested and what the result will mean.

Helpful Questions Include:

Does my pain pattern fit pudendal neuralgia?
Could this pain be coming from pelvic floor dysfunction, hip, SI joint, lumbar spine, prostate, urologic, gynecologic, colorectal, or another cause?
Is the block diagnostic, therapeutic, or both?
Is the technique transvaginal?
Will fluoroscopy or another image guidance method be used?
Will contrast be used to confirm spread?
What medication will be injected?
How much relief would count as a positive response?
How long should relief last?
What should I track after the block?
What are the risks for my specific situation?
What are the next steps if the block helps?
What are the next steps if the block does not help?

The Best Question Before the Block

Ask: “What pudendal nerve pain pattern are we testing, and what will we do differently depending on the result?” If the answer is clear, the block has a purpose.

Pudendal nerve block is part of a broader nerve pain care map. Patients with overlapping pelvic, buttock, groin, spine, hip, or post-surgical symptoms may also benefit from related topics.

Frequently Asked Questions About Pudendal Nerve Block

What is a pudendal nerve block?

A pudendal nerve block is an injection placed near the pudendal nerve, a pelvic nerve that can contribute to pain in the perineal, rectal, anal, genital-region, pelvic floor, and sitting areas.

What does a pudendal nerve block treat?

This block may be considered for pudendal neuralgia, pudendal nerve entrapment, pelvic nerve pain, perineal pain, rectal-region nerve pain, genital-region nerve pain, sitting pain, and selected post-surgical or trauma-related pelvic nerve pain.

Is your pudendal nerve block transvaginal?

No. Our technique is not transvaginal. We use an external image-guided approach, usually with the patient positioned face down, to target the pudendal nerve region near pelvic landmarks.

Do you treat male patients with pudendal nerve pain?

Yes. Pudendal neuralgia can affect male and female patients. Male patients may experience penile, scrotal, perineal, rectal, anal, pelvic floor, or sitting pain when the pudendal nerve is involved.

What symptoms suggest pudendal neuralgia?

Pudendal neuralgia may cause burning, shooting, stabbing, electric, raw, pressure-like, or hypersensitive pain in the perineal, rectal, anal, genital, or pelvic floor region. Pain often worsens with sitting in classic cases.

How does the block work?

The block places medication near the pudendal nerve pathway. Local anesthetic may temporarily numb the nerve, while steroid or another medication may reduce irritation or inflammation depending on the treatment plan.

Is the block diagnostic or therapeutic?

It can be both. If numbing the pudendal nerve temporarily relieves the familiar pain, the block may help confirm the diagnosis. If relief lasts longer, it may also provide therapeutic benefit.

How long does relief last?

Relief varies. Some patients feel relief only for a few hours while the local anesthetic is active. Others may improve for days, weeks, or longer if nerve irritation or inflammation decreases.

What if the block helps only briefly?

A short but strong response may still be diagnostically meaningful. It may suggest that the pudendal nerve is part of the pain pathway, even if longer-lasting treatment is needed.

What if the block does not help?

If the block does not help, the pudendal nerve may not be the main pain source, the target may need reconsideration, or the pain may be coming from another structure such as pelvic floor muscles, sacral nerve roots, SI joint, hip, prostate, bladder, gynecologic, colorectal, or another pelvic nerve source.

Is image guidance used?

Yes. Image guidance is used to identify pelvic landmarks, guide needle placement, and improve confidence that the intended pudendal nerve region is being tested.

Is the procedure painful?

Patients may feel pressure, soreness, or brief discomfort. Sedation may be considered depending on the patient, setting, and physician judgment.

What are the risks?

Risks may include soreness, bruising, bleeding, infection, temporary numbness, temporary pain flare, nerve irritation, nerve injury, allergic reaction, local anesthetic side effects, vascular injury, hematoma, temporary leg numbness or weakness, temporary bowel or bladder changes, and failure to improve.

Can the block be repeated?

It may be repeated in selected cases when the first block provides meaningful relief and the diagnosis supports repeating treatment. Some patients may undergo a second confirmatory block before considering longer-term options.

What are the next steps if the block works?

Next steps may include observation, pelvic floor therapy, medication adjustment, repeat block, confirmatory block, pulsed radiofrequency treatment, peripheral nerve stimulation, or specialist referral depending on the response and diagnosis.

Is this nerve block covered by insurance?

Coverage depends on the diagnosis, payer policy, medical necessity, documentation, medication used, image guidance, and whether prior authorization is required.

Key Takeaways

A pudendal nerve block targets a deep pelvic nerve that may contribute to pelvic, perineal, rectal, anal, genital-region, or sitting pain.
Pudendal neuralgia can affect both male and female patients.
Our technique is not transvaginal and is performed using an external image-guided approach.
Classic pudendal neuralgia often worsens with sitting, though symptoms can vary.
Pelvic pain has many possible causes, so diagnosis must come before the injection.
A short but strong response can be diagnostically meaningful.
Longer relief may occur when nerve irritation or inflammation improves.
No relief may mean the diagnosis, target, or pain generator needs to be reconsidered.
Image guidance helps identify pelvic landmarks and improve confidence in the target.
Next steps may include pelvic floor therapy, medication adjustment, repeat block, pulsed radiofrequency, peripheral nerve stimulation, or specialist referral in selected cases.

Is the Pudendal Nerve Causing Your Pelvic or Sitting Pain?

Pelvic, perineal, rectal, genital-region, and sitting pain can come from many sources. The key is deciding whether the pudendal nerve is truly part of the pain pathway.

At SpinePain Solutions, we evaluate the pain pattern, sitting tolerance, pelvic history, examination findings, imaging when appropriate, and prior treatments to decide whether a targeted pudendal nerve block or another approach makes sense.

Schedule a Consultation

This article is intended for educational purposes only and should not replace individualized medical advice. Pelvic pain, perineal pain, rectal pain, genital-region pain, sitting pain, pudendal neuralgia, pelvic floor dysfunction, prostate conditions, gynecologic conditions, urologic conditions, colorectal conditions, spine pain, hip pain, SI joint pain, and other pelvic nerve conditions can have multiple causes. New, severe, unexplained, or concerning symptoms should be evaluated promptly. Treatment decisions should be based on a complete history, physical examination, imaging review when appropriate, diagnosis, risks, benefits, alternatives, and a discussion with your physician.