Pudendal neuralgia is a condition that for many can be very scary, depressing, and anxiety-invoking. Many people take a very long time to get properly diagnosed and have seen multiple health providers. In this article, we discuss pudendal neuralgia and treatment through physical therapy.

What is Pudendal Neuralgia?

Pudendal neuralgia (also referred to as Alcock’s syndrome) is a condition that can cause persistent pain or numbness along the course of the pudendal nerve, a nerve that innervates the pelvic floor, rectum, and genitals, and can contribute to pain in these regions - particularly when sitting.

Symptoms of Pudendal Neuralgia

This is because pudendal neuralgia can present in different ways in different people, making it tricky and easy to miss. Here are some different ways that pudendal neuralgia can present: 

Burning, numbness, tingling, or pain in the pelvic area

Pudendal neuralgia is irritation of the nerves that go to the pelvic floor. When nerves are irritated, we often hear words such as burning, numbness and tingling. However, sometimes people just report pain without the other more classic “nerve words”. This can make it more confusing and difficult to zero in on the nerves as the driver for the discomfort. 

Tailbone pain, or pain with sitting

Just because someone has tailbone pain or pain with sitting does not necessarily mean that they have pudendal neuralgia. However, sometimes the nerve can really be the driver of these symptoms. The similar presentation of tailbone pain with or without nerve involvement makes it harder to diagnose, but choosing to address the nerve or not is highly important for treatment through physical therapy.

Urgency/frequency

The pudendal nerve feeds the muscles of the pelvic floor, and when irritated, causes the muscles to tense up. The increased tension in the pelvic floor muscles can lead to a plethora of symptoms including urgency or frequency of urination. However, similar to tailbone pain, just because someone has urgency/frequency does not necessarily mean that the nerve is irritated. 

Pudendal Neuralgia and Physical Therapy

Treating pudendal neuralgia can require multidisciplinary care which often includes urogynecology, physical therapy, and more. 

Pelvic floor physical therapy is extremely important for treating pudendal neuralgia and is a first-line treatment. Intervention for treating this condition usually includes pelvic floor muscle relaxation and treating external musculoskeletal problems including low back pain and hip problems. Treatment for this condition is very individualized as people present with different combinations of symptoms and impairments. 

If you are ready to solve your pudendal neuralgia problem for good, speak to one of our pelvic floor experts today! We treat several Maryland areas, including Gaithersburg, Frederick, and Columbia.