chronic pain pelvic health pelvic pain pudendal neuralgia

Pudendal Neuralgia Symptoms and Causes

Pudendal neuralgia symptoms can be painful and worrying, so should be diagnosed quickly. Find out more about pudendal neuralgia, its symptoms and causes...

The pudendal nerve is probably not something you’re aware you have until you develop a problem with it. The nerve runs from the lower back, along the muscles of the pelvic floor and into the perineum (the area between the anus and the scrotum or vulva). If you’re feeling pain in this area, you may have pudendal neuralgia. Pudendal neuralgia symptoms can be quite unpleasant, but don’t worry… there are things you can do about it.

The term pudendal neuralgia refers to chronic pain around the pudendal nerve. To get a clearer picture of how this happens, it may help to consider how nerves function. Nerves can actually stretch quite easily, and they can also be squashed. That’s how we get those ‘pins and needles’ feelings when we’ve crossed our legs for too long or slept awkwardly on an arm. Fortunately, nerves bounce back pretty quickly most of the time so these sensations are short-lived.

However, there are times when we may accidentally traumatize a nerve. For example, we might have a nasty fall. We might also traumatize our nerves through repetitive movements that result in wear and tear (such as typing, or certain kinds of exercise).

Pudendal neuralgia symptoms

When your nervous system becomes sensitized to this kind of pain, the pain response is greater and can be triggered more easily. When this happens to the pudendal nerve you may experience a number of different pudendal neuralgia symptoms.

Pain is the most common symptom of pudendal neuralgia, but the sensations can vary greatly from person to person, as can the intensity. Typical pain sensations range from:

  • Burning sensations
  • Aching
  • Shooting pains
  • Itching
  • Over sensitivity

Both sexes experience these kinds of pain, but for women it is usually centered around the clitoris, labia, and/or vagina. It can also be felt in the urethra, anus or perineum.

Other areas susceptible to pudendal neuralgia symptoms

Pudendal neuralgia symptoms can occur in other areas around the pelvic region too. For example, irritation or pain may be felt in:

  • The bowel
  • The bladder
  • The buttocks
  • The legs
  • The feet  

It might be surprising to hear that you can feel this pain in your feet, legs and buttocks, but this is a referred pain. It happens because the skin in these areas is supplied by the same area of the spine, so your brain can interpret the pain as having come from there.

Causes of pundendal neuralgia

Pudendal neuralgia can happen because the pudendal nerve is somehow traumatized. Here are some of the more common pudendal neuralgia causes:

  • Difficult childbirth
  • Pelvic or perineal injury or trauma
  • Surgery in the pelvic area
  • Straining due to constipation
  • Poor posture
  • Too much exercise (e.g. cycling or horse riding)
  • Stress

Your pudendal neuralgia symptoms may also be down to nerve compression; for instance, you might have large pelvic floor muscles or tight ligaments – both can cause compression of the nerve. Sometimes there is more than one reason for pudendal neuralgia, and it may be difficult to pinpoint them.

Note that the symptoms of pudendal neuralgia may feel a lot like the symptoms of vulvodynia, another pain condition in the vulva. Your Doctor should be able to differentiate between this and pudendal neuralgia.

However, both conditions can lead to sexual problems and difficulties in sitting comfortably, so if you are experiencing what seems to be pudendal neuralgia symptoms, it is important to get them checked out so that you can start treating the problem. We will shortly be covering pudendal neuralgia treatment options, so don’t forget to follow our blog for further information on this subject.



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