If you experience pelvic pain that worsens when sitting, during sex, or while cycling, it may be linked to a condition called pudendal neuralgia. Though less known, this nerve-related pain can deeply affect quality of life. The good news? With the right diagnosis and treatment, recovery is possible.

What Is Pudendal Neuralgia?

The pudendal nerve is a key nerve in the pelvis that supplies sensation to the perineum, genitals, and pelvic floor muscles.
When irritated, compressed, or injured, it can cause chronic pelvic pain: this is known as pudendal neuralgia.

Common Symptoms

Pain, burning, tingling, or numbness in the perineum or genitals
Pain that worsens when sitting and improves when standing or lying down
Pain with sexual activity, tampon use, or gynaecological exams
Discomfort while cycling or prolonged sitting
Possible bladder, bowel, or pelvic floor dysfunction

👉 Symptoms can vary from mild discomfort to severe, daily pain.

What Causes Pudendal Neuralgia?

Childbirth trauma (stretching or compression of the nerve)
Pelvic surgery or scarring
Repetitive activities like cycling or prolonged sitting
Pelvic floor dysfunction (muscle overactivity or spasm compressing the nerve)
Sometimes, the exact cause remains unclear

How Is It Diagnosed?

Diagnosis is clinical and may involve:

Medical history and physical exam
Pelvic floor assessment (always with your consent, internal exams are optional)
Imaging or nerve tests (if needed)
Ruling out other causes of pelvic pain

Evidence-Based Treatment Options

1. Pelvic Floor Physiotherapy

Learning to relax overactive muscles that may irritate the nerve
Postural and movement strategies to reduce compression
Breathing and relaxation techniques

2. Lifestyle Adaptations

Using cushions or cut-out seats to reduce pressure when sitting
Adjusting cycling posture or avoiding aggravating activities temporarily

3. Medical & Multidisciplinary Approaches

Medications for nerve pain
Local injections (nerve blocks) in some cases
Collaboration between physiotherapists, pain specialists, and gynaecologists

Pudendal neuralgia can feel overwhelming, but you are not alone. With early recognition, physiotherapy, and a multidisciplinary approach, pain can be managed and quality of life improved.

✨ Experiencing pelvic pain when sitting, cycling, or during sex? Book a consultation with our women’s health physiotherapists at Renard Clinic for evidence-based support and relief.