Neuropathic pain is chronic (long term) pain resulting from injury or damage to nerves. This type of pain is difficult to manage. There has been little research on neuropathic pelvic or perineal pain.
Treatment possibilities include nerve blocks of various types, medication (some medications are of limited benefit with this type of pain and side effects can be significant for some patients), physical therapy, surgery and self-care. Botox is used for some conditions and in some countries as are sacral nerve stimulation and intrathecal pain pumps. Cognitive behavioural therapy is included as a part of pain management programmes. The quality of such programmes may vary and the content may be geared more towards some conditions such as back pain than others such as pelvic or perineal pain. In addition patients may still need ongoing support following completion of such a programme.
A detailed information sheet about nerve blocks is available from: info@pelvicpain.org.uk
Pudendal Neuralgia
Pudendal neuralgia is an illness which involves neuropathy of the pudendal nerve. According to the International Association of Pudendal Neuropathy, the incidence of pudendal neuralgia in the general population is about 1/100,000.
Pudendal neuralgia is caused by inflammation, compression and traction of the pudendal nerve. It may be associated with childbirth, pelvic surgery, strenuous exercise, abnormalities of the sacroiliac joint, and also, it is connected to age-related changes.
Full article by the Journal of Pain Research can be found here:
The Pelvic Pain Support Network has produced an Information Standard accredited leaflet on the diagnostic criteria and the current approaches to managing pudendal neuralgia. This can be sent by post. Please contact: info@pelvicpain.org.uk
The following link provides information about the assessment of long term pain:
https://fpm.ac.uk/opioids-aware-understanding-pain-medicines-pain/assessment-long-term-pain
Further Information
- https://pubmed.ncbi.nlm.nih.gov/34643963/ Eur J Pain . 2022 Jan;26(1):7-17. Recommendations on the management of pudendal nerve entrapment syndrome: A formalised expert consensus.
- https://www.ncbi.nlm.nih.gov/books/NBK544272/ Pudendal Nerve Entrapment Syndrome J Kaur; Stephen W. Leslie; P Singh.
- https://pubmed.ncbi.nlm.nih.gov/39873912/ Review Curr Pain Headache Rep . 2025 Jan 28;29(1):38. Pudendal Neuralgia: A Review of the Current Literature
Rosalynn R Z Conic 1 , Prabhleen Kaur 2 , Lynn R Kohan 3 - https://pubmed.ncbi.nlm.nih.gov/41553637/ Review Curr Pain Headache Rep . 2026 Jan 19;30(1):22. Minimally Invasive Interventional Management of Pudendal Neuralgia: A Narrative Review
C M Lam # 1 , C L Robinson # 2 , K Kuester 3 , J Lee Tate 4 , K Patel 5 , U Latif 6 - https://pubmed.ncbi.nlm.nih.gov/39607531/ Meta-Analysis Int Urogynecol J . 2025 Jan;36(1):35-58. Impact of Treatment of Pudendal Neuralgia on Pain: A Systematic Review and Meta-Analysis
Sarah E Andiman 1 , Julia S Maron 2 , Vani Dandolu
