For Health Practitioners

Pain where you sit – Pudendal Neuralgia

Pain where you sit – Pudendal Neuralgia

Pain where you sit – Pudendal Neuralgia

Pudendal Neuralgia is a pain you may not have heard of before. The pudendal nerve is the nerve that goes to the muscles and skin between our legs where we sit. Some people call this the ‘saddle area’, which means that it affects the part of you that would touch a saddle if you were riding a horse.

The pudendal nerve travels through some tight places around the inside of your pelvis, where it can get irritated or be put under pressure, especially with cycling or childbirth. Sometimes no cause for the problem is found.

What are the symptoms of pudendal neuralgia?

There are many different symptoms, but they are usually worse when sitting. The symptoms include:

  • pain in the vicinity of the pudendal nerve-anywhere from the clitoris or penis back to the anal area. It may be on one or both sides, near the front, or further back. This pain is usually a burning or sharp ‘electric’ feeling.
  • sexual problems with less feeling in the penis or clitoris
  • difficulty opening your bowels
  • numbness in the area affected

What can I do to help the problem?

When you sit, use a ‘U-shaped’ foam cushion with the front and centre area cut out, or sit on two towels rolled up under each buttock so there is no pressure in the centre. While pressure on the pudendal nerve may have been the problem that started the pain, it is common for pelvic muscle pain or spasm to develop as well. Tight pelvic muscles can also be the cause of pressure on the nerve. They are commonly interrelated. Once pain has been present for more than three to six months, there may also be changes to nerve pathways described as chronic pain.

A pelvic physiotherapist who understands how to ‘down train’ pelvic muscles (not tighten them) can teach you how to relax and lengthen your pelvic muscles, taking pressure off the nerve and reducing muscle pain.

Avoid straining when you pass urine or open your bowels, and avoid overly strengthening your pelvic muscles.

Some centres offer botox to the pelvic floor muscles or pudendal nerve blocks for this problem.

To help the nerve recover, you should avoid activities that place pressure on the nerve, such as sitting or cycling.

Pudendal Hope Brochure

For more information, we highly recommend this brochure on Chronic Pelvic Pain, Genital Pain and Pudendal Neuralgia, from It describes the diagnosis and management of Pudendal Neuralgia.

Health Organisation for Pudendal Chronic Pain brochure (569kb)

The Patient Journey – Judy’s Story

From the Women’s Health & Research Institute of Australia
Use the password ‘pudendal‘ to view the video on

WHRIA Judy’s Story from WHRIA

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