Overview
The pudendal nerve travels through the pelvis and supplies sensation to the pelvic floor and genital region. Irritation or entrapment can lead to burning, stabbing, aching, or hypersensitive pain. Symptoms often worsen with sitting and may improve with standing or lying down. Pain may occur after childbirth, pelvic surgery, trauma, prolonged sitting, or as part of a broader pelvic pain condition.
A pudendal nerve block delivers local anaesthetic, sometimes with steroid medication, around the nerve. The aim is to reduce inflammation, calm nerve sensitivity, interrupt pain signals, and help confirm whether the pudendal nerve is contributing to symptoms.
Who This Treatment Helps
A pudendal nerve block may be suitable for people with:
• Pelvic, perineal, or genital pain
• Pain worse with sitting and relieved by standing in some cases
• Burning, tingling, sharp, or electric like pain patterns
• Symptoms after childbirth, pelvic surgery, trauma, or prolonged sitting
• Suspected pudendal neuralgia
• Limited improvement from pelvic floor therapy or medication
A consultation is needed to confirm suitability.
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. The block can be diagnostic by confirming nerve involvement when symptoms improve, and therapeutic by reducing inflammation and sensitivity over time.
What to Expect During the Procedure
You will be positioned comfortably depending on the approach used. The skin is cleaned and numbed, then a fine needle is guided into place using imaging. Medication is delivered around the nerve, and you are monitored before going home the same day.
After the Procedure
Temporary numbness in the pelvic region can occur. Mild soreness at the injection site is common. Some patients notice immediate improvement from the local anaesthetic, while steroid benefit may build over 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 blocks are generally safe. Potential risks include:
• Temporary increase in pain
• Local bruising or soreness
• Temporary numbness
• Infection rare
• Bleeding
• Allergic reaction uncommon
• Very rarely irritation of nearby nerves or structures
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 thinners, allergies, diabetes, pregnancy, and recent infections. Avoid driving if numbness persists.
Arrange a consultation to discuss whether a pudendal nerve block may help your symptoms.