Chronic Pelvic Pain & Pudendal Neuralgia
Persistent pelvic pain is one of the most complex chronic pain presentations — involving potential contributions from pelvic nerves, the sympathetic nervous system, and myofascial structures. Interventional pain management plays an important role when nerve-mediated pain is a driving factor.
Understanding Chronic Pelvic Pain
Chronic pelvic pain is defined as persistent pain in the lower abdomen or pelvis lasting six months or longer. It can arise from multiple overlapping sources — including nerve entrapment or irritation in the pelvic region, sensitization of the sympathetic nervous system, myofascial pain in the pelvic floor muscles, or a combination of these mechanisms. Because these contributing factors are often intertwined, effective treatment typically requires a multidisciplinary approach involving interventional pain management alongside gynecology, urology, and pelvic floor physical therapy.
Pudendal neuralgia is a specific and often underdiagnosed form of chronic pelvic pain caused by irritation or entrapment of the pudendal nerve — the main sensory nerve of the perineum, genitals, and anal region. It produces burning, stabbing, or aching pain in these areas, typically worse with sitting and relieved by standing. It may develop after childbirth, cycling, surgery, or without an obvious cause, and is frequently missed for years before accurate diagnosis.
How We Approach Chronic Pelvic Pain
Our evaluation begins with a thorough history focused on the distribution, quality, and triggers of your pain — and a review of any prior evaluation or treatment, including gynecologic, urologic, and gastrointestinal workup. Interventional options include pudendal nerve blocks for pudendal neuralgia (which serve both diagnostic and therapeutic roles), superior hypogastric plexus blocks for central pelvic pain with sympathetic involvement, ganglion impar blocks for perineal and coccygeal pain, and trigger point injections for pelvic floor myofascial pain.
For patients with refractory pelvic pain, spinal cord stimulation may be considered. We work collaboratively with gynecology, urology, and pelvic floor physical therapy to coordinate care — because no single specialty manages all aspects of chronic pelvic pain effectively on its own. A consultation will help clarify which components of your pain have an interventional solution.
Common Questions
Schedule a Consultation
Our clinical team will evaluate your pelvic pain and determine which interventional approaches are most appropriate for your specific situation.