Paincare Florida

Pudendal Nerve Block

Pain Treatment Procedure

Pudendal Nerve Block

A pudendal nerve block is a minimally invasive injection that targets the pudendal nerve, a major nerve in the pelvis that carries pain signals from your pelvic region.[1] This minimally invasive procedure calms the pudendal nerve, providing powerful relief for chronic pelvic pain that hasn’t improved with other treatments. [2]

From sitting comfortably to going about daily routines, pelvic pain can greatly impact your quality of life. Pudendal nerve blocks are designed to ease this pain and, in many cases, help your provider better understand the source of your symptoms.[3]

How Pudendal Nerve Blockades Work

The pudendal nerve provides sensory and motor function to the genitals (penis, vagina and vulva), anus, and perineum (the area between the anus and genitals), sphincter and pelvic muscles in both men and women.[1] This nerve runs deep in the pelvis, so the injection is typically guided by imaging to ensure accuracy and safety. [4; 5] During the procedure, your pain management specialist injects a local anesthetic and a steroid near the nervus pudendus or internal pubic nerve.[1]

The anesthetic temporarily “turns off” the pudendal nerve’s pain signals to the brain, while the steroid reduces inflammation that may be irritating the nerve.[6] Most patients feel relief within minutes to hours, though the duration of relief varies. For some, the results may last days to weeks, while others experience longer-lasting benefits. [1]

Conditions Treated with Pudendal Nerve Block

Pudendal nerve blocks may be used both as a diagnostic tool and as a treatment for chronic pelvic pain disorders and tailbone or SI joint pain.[3] They are often recommended when pain is traced to irritation, entrapment, or inflammation of the pudendal nerve.

Conditions that may respond to this procedure include:

  • Pudendal neuralgia (chronic pain in the pelvic region linked to nerve irritation or entrapment) [7]
  • Chronic pelvic pain in men or women, especially when other causes have been ruled out [6]
  • Levator ani syndrome (pelvic floor muscle spasms) [6]
  • Pain after pelvic surgery or trauma [4]
  • Pain with sitting, bowel movements, or sexual activity [8; 1]
  • Diagnostic purposes [8]
  • Vulvodynia (chronic vulva pain) [3]
  • Coccygodynia or pain around the coccyx or tailbone (the bony structure at the base of the spine) [9]
  • Sacroiliac joint dysfunction or painful inflammation of the SI joints [9]

Benefits of Pudendal Blockades

Living with chronic pelvic pain or lower back discomfort can feel overwhelming, but a pudendal nerve block may help break the cycle. Here are some of the main benefits:

  • Targeted Pain Relief: The medication is delivered directly to the pudendal nerve, calming irritation at the source instead of affecting your whole body [4]
  • Fast-Acting Results: Many patients notice relief within hours of the injection [2]
  • Reduced Reliance on Medications: Pudendal nerve blocks may help decrease the need for opioids or other systemic medications that can cause unwanted side effects [3]
  • Minimally Invasive: This outpatient procedure requires no stitches or long recovery time, and most people go home the same day [2]
  • Improved Daily Function: By easing pain, nerve blocks can help you sit, walk, and return to physical therapy or everyday routines more comfortably [6]
  • Diagnostic Value: The block can help your physician confirm whether pudendal nerve irritation is the main cause of your pain [2]

Consult a Pudendal Nerve Block Specialist for Pain Management

You may be a good candidate for pudendal blockade if your pelvic pain hasn’t improved with medication and conservative care. If you’ve noticed your pain increases when sitting, bowel movements or sexual activity, those are classic signs that your pudendal nerve is involved.

It’s understandable to feel embarrassed or hesitant to discuss your chronic pelvic pain, but you don’t have to suffer in silence. Pain management specialists can help. They treat these symptoms regularly and understand what you’re experiencing.

A pudendal nerve block is most effective when it’s part of a comprehensive treatment plan. Your pain specialist may combine your injection with pelvic floor therapy, lifestyle changes and other interventional options to support long-term relief.

Don’t let chronic pelvic pain (or any pain) control your life. Pudendal nerve blocks may be the answer you’ve been seeking. Your pain management physician will determine if this procedure is suitable for you.

Resources:

  1. Grujicic R. Pudendal nerve. Ken Hub [Internet]. Reviewed October 30, 2023. Accessed August 30, 2025. Available from: https://www.kenhub.com/en/library/anatomy/pudendal-nerve
  2. Pudendal Nerve Block. Cleveland Clinic [Internet]. Accessed August 30, 2025. Available from: https://my.clevelandclinic.org/health/treatments/24917-pudendal-nerve-block
  3. Pudendal Nerve Decompression – Medical Clinical Policy Bulletins. Aetna [Internet]. Published 2016. Accessed August 30, 2025. Available from: https://www.aetna.com/cpb/medical/data/800_899/0805.html
  4. Satpathy HK, Fleming AD, Fossen KA, Frey DR. Transvaginal Pudendal Nerve Block. Medscape [Internet}. Updated December 09, 2020. Accessed August 30, 2025. Available from: https://emedicine.medscape.com/article/83078-overview
  5. Hough DM, Wittenberg KH, Pawlina W, et al. Chronic Perineal Pain Caused by Pudendal Nerve Entrapment: Anatomy and CT-Guided Perineural Injection Technique. American Journal of Roentgenology [Internet]. 2003;181(2):561-567. doi:https://doi.org/10.2214/ajr.181.2.1810561 Accessed August 30, 2025. Available from: https://ajronline.org/doi/10.2214/ajr.181.2.1810561
  6. Ghanavatian S, Leslie SW, Derian A. Pudendal Nerve Block. [Updated 2024 Sep 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Accessed August 30, 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551518/
  7. Pudendal Neuralgia. Physiopedia [Internet]. Accessed August 30, 2025. Available from: https://www.physio-pedia.com/Pudendal_Neuralgia
  8. PUDENDAL NEUROPATHY AND ITS PIVOTAL ROLE IN PELVIC FLOOR DYSFUNCTION AND PAIN. International Continence Society and the International Urogynecological Association [Internet]. Accessed August 30, 2025. Available from: https://www.ics.org/workshops/handoutfiles/000116.pdf
  9. Kaur J, Leslie SW, Singh P. Pudendal Nerve Entrapment Syndrome. [Updated 2023 Aug 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Accessed August 30, 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544272/
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