Pudendal nerve entrapment syndrome is a long-term pelvic pain condition that results from damage, irritation or compression of one of the main nerves in the pelvis, called the pudendal nerve.
The pudendal nerve runs from your lower back, along the pelvic floor muscles to your perineum (the area of skin between your vagina and anus), where it branches off to the clitoris, vulva and rectum. This can cause a great deal of pain and discomfort and in some cases may significantly impact quality of life.
What is pudendal nerve entrapment?
What causes pudendal nerve entrapment?
Symptoms of pudendal nerve entrapment
How is pudendal nerve entrapment diagnosed?
Treating and managing pudendal nerve entrapment
Risks and complications
What you can do
Pudendal nerve entrapment syndrome (also known as Alcock syndrome or pudendal neuralgia) is a chronic pelvic pain condition related to the pudendal nerve. This condition causes vulval pain.
The pudendal nerve carries sensations from the external genitals and the skin around the anus and perineum. It also controls the sphincter muscles that open and close when you have a bowel movement (poo).
Pudendal nerve entrapment syndrome may be caused by:
The most common symptom is pain when sitting, which gets worse the longer you sit. This pain may be burning, shooting, aching, itching or like an electric shock. You may feel it in your clitoris, labia, vagina, urethra, anus or rectum.
You may also experience:
Diagnosing pudendal nerve entrapment syndrome is usually done via a clinical examination and some other tests. Your doctor will ask about your medical history, your symptoms and the location of symptoms. If your doctor suspects your pudendal nerve is involved, they will probably arrange for some other tests which may include:
There is no ‘cure’ for pudendal nerve entrapment. Rather, treatment aims to manage and reduce symptoms. This is usually done through a combination of approaches including lifestyle changes, physiotherapy and medical treatment.
Lifestyle changes involve avoiding activities that make the pain worse, such as:
Physiotherapy treatment to help you relax and stretch your pelvic floor muscles and other muscles that may irritate the pudendal nerve can be helpful. These work by taking pressure off the nerve and reducing muscle pain. Physiotherapy can also help if you have trouble controlling your bladder or bowels.
Your physiotherapist may also recommend the use of a TENS (trans-cutaneous electrical nerve stimulation) machine to help relieve your pain. Be sure to ask your physio to show you where to apply the electrodes correctly.
Managing pudendal nerve entrapment through medication is similar to managing other chronic pain syndromes. It may involve:
Injections of local anaesthetic or steroid medication may also provide relief for up to a few months at a time.
If your nerve pain is due to compression from a lesion or growth, surgery can be effective in improving your pain. However, in some cases the effects of prolonged compression can still affect nerve function so eliminating all symptoms may not be realistic.
Neurostimulation may also help manage symptoms. This involves surgically implanting a small device under your skin, which delivers mild electrical impulses to the nerve to block pain signals from reaching the brain.
Pudendal nerve entrapment can have a significant impact on your life. The condition can cause ongoing pain and discomfort and interfere with the ability to enjoy every-day activities. The condition can also lead to:
If you notice pelvic und vulval pain of any kind it’s important to see your doctor. If left untreated, pudendal nerve entrapment can get worse over time.
Early treatment of any condition causing pelvic and vulval pain often leads to better outcomes.
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at April 2021.
