Pudendal Neuralgia Physiotherapy in Norwich
Pudendal neuralgia is pain associated with irritation or damage to the pudendal nerve, one of the main nerves supplying the pelvic floor, perineum, genitals, and anal region. Symptoms can affect people of any sex and may be particularly aggravated by sitting.
Diagnosis can be complex. Pelvic health physiotherapy may form part of a wider plan with your GP, pain specialist, neurologist, urologist, gynaecologist, or colorectal team.
Which Cliniko appointment should I book?
If this is your first appointment for this concern, choose Initial Pelvic Health – 60 mins (for women and men) or Initial Pelvic Health – 45 min Express Check (for women and men). If Ellie has already assessed you for this concern, choose Follow-up Pelvic Health – 45 mins or Follow-up Pelvic Health – 60 mins.
Common symptoms
- Burning, shooting, tingling, electric, or aching pain in the genitals, perineum, anus, or pelvis.
- Numbness or altered sensation.
- Pain that is worse while sitting and may build through the day.
- Discomfort with cycling, prolonged driving, or activities that load the pelvic region.
- Bladder, bowel, or sexual symptoms occurring alongside pain.
- Pelvic floor tension or difficulty relaxing the muscles.
Similar symptoms can have other causes, so persistent genital, anal, perineal, or pelvic pain should be medically assessed.
How physiotherapy fits into treatment
Physiotherapy does not diagnose every cause of pudendal neuralgia or replace medical investigation. It can help when pelvic floor overactivity, muscle guarding, movement, posture, loading, or repeated nerve irritation contribute.
Your plan may include:
- Pelvic floor relaxation and coordination.
- Breathing and nervous-system regulation strategies.
- Gentle treatment for contributing muscle tension where appropriate.
- Reviewing sitting, work, driving, cycling, lifting, and exercise exposure.
- Pacing and graded return to activity.
- Strategies to reduce straining with bladder or bowel emptying.
- Advice on cushions or position changes to reduce pressure while sitting.
- Communication with your medical team when symptoms need further investigation or pain-management input.
Treatment should not aggressively stretch or strengthen an irritable pelvic floor without assessment. The approach is guided by your symptoms and response.
Seek urgent medical help if
New loss of bladder or bowel control, numbness around the saddle area, progressive leg weakness, severe back pain with neurological symptoms, fever, or sudden severe pelvic pain requires urgent medical assessment.
FAQ
Is pudendal neuralgia always caused by nerve entrapment? No. Pudendal nerve pain can have several causes, and symptoms may overlap with pelvic floor or other pelvic pain conditions. A medical assessment helps guide diagnosis.
Can physiotherapy help if sitting is painful? It may help identify pelvic floor, movement, pressure, and activity factors that aggravate symptoms and build a practical management plan.
Should I stop all exercise? Usually not. The aim is to identify and temporarily modify aggravating activities, then rebuild tolerance rather than becoming completely inactive.
Will I need an internal examination? Not necessarily. It is only considered when clinically useful and with your explicit consent.
Further information
For an individual pelvic health assessment as part of your wider care, view appointments and book.