Overview
Pudendal nerve block is a targeted treatment used when irritation of the pudendal nerve is contributing to pelvic pain. The pudendal nerve travels through the pelvis and supplies sensation to the pelvic floor and genital region. When this nerve becomes irritated or entrapped, symptoms may include burning, stabbing, aching, hypersensitivity, or sharp nerve related pain.
Pudendal nerve block may be considered when pain is worse with sitting and improves with standing or lying down. Symptoms can develop after childbirth, pelvic surgery, trauma, prolonged sitting, or as part of a broader pelvic pain condition. A pudendal nerve block aims to reduce inflammation, calm nerve sensitivity, interrupt pain signals, and help confirm whether the pudendal nerve is a significant source of symptoms.
Who this treatment helps
Pudendal nerve block may be suitable for people with:
- Pelvic, perineal, or genital pain
- Pain that worsens with sitting and may improve with standing
- Burning, tingling, sharp, or electric like pain patterns
- Symptoms after childbirth, pelvic surgery, trauma, or prolonged sitting
- Suspected pudendal neuralgia
- Limited improvement with pelvic floor therapy or medication
A consultation is needed to confirm suitability and to determine whether the pudendal nerve is likely to be contributing to the pain pattern.
What is a pudendal nerve block
A pudendal nerve block is a targeted injection delivered near the pudendal nerve. The injection typically contains:
- Local anaesthetic to temporarily numb the nerve
- Steroid medication to reduce inflammation
Imaging guidance such as ultrasound, X ray guidance, or CT may be used to improve accuracy and safety. Pudendal nerve block can be used in two ways. It can be diagnostic by confirming nerve involvement when symptoms improve, and it can be therapeutic by reducing inflammation and sensitivity over time.
What to expect during the procedure
Your consultant will explain the plan and answer any final questions before the procedure begins.
- You will be positioned comfortably depending on the approach used
- The skin is cleaned and numbed with local anaesthetic
- A fine needle is guided into place using imaging guidance
- Medication is delivered around the pudendal nerve
- You are monitored briefly before going home the same day
The exact approach depends on the area of pain and the safest route to the nerve.
After the procedure
Temporary numbness in the pelvic region can occur after pudendal nerve block. Mild soreness at the injection site is also common for a short period.
Some people notice early improvement from the local anaesthetic, while steroid benefit may build over several days.
Your consultant may advise:
- Avoid strenuous activity for 24 to 48 hours
- Continue pelvic floor therapy if recommended
- Use seating strategies to reduce pressure if sitting worsens symptoms
- Monitor symptoms and report any concerns
Benefits
- May reduce pelvic, perineal, or genital pain
- Helps confirm pudendal nerve involvement
- Minimally invasive with short recovery time
- Can improve sitting tolerance and daily activity
- May reduce reliance on medication
- Supports progress with pelvic floor rehabilitation
Possible risks and side effects
Pudendal nerve block is generally safe when performed by experienced clinicians, but all procedures carry some risk.
- Temporary increase in pain
- Local bruising or soreness
- Temporary numbness
- Infection, which is rare
- Bleeding
- Allergic reaction, uncommon
- Very rarely irritation of nearby nerves or structures
Your consultant will explain the expected benefits, possible risks, and alternative options during assessment.
When to consider other options
If symptoms do not improve or suggest an additional pain pathway, your consultant may discuss ganglion impar block, hypogastric plexus block, caudal epidural, medication optimisation, or multidisciplinary pelvic pain management.
Safety note
Please inform your consultant about blood thinning medication, allergies, diabetes, pregnancy, and recent infection before treatment. Avoid driving if numbness persists after the procedure.
Arrange a consultation to discuss whether pudendal nerve block may help your symptoms.
You can also explore our pelvic pain treatments, learn more about sacroiliac joints injection, genito femoral nerve block, ilio inguinal nerve block, or view our pain treatments.