The pudendal nerve is the main nerve of the perineum. The perineum is the area between the testicles and anus of a man, and the vagina and anus of a woman. When this nerve suffers an injury, it can result in the most chronic and disabling form of pelvic pain, pudendal neuralgia.
Although pudendal neuralgia has come to be used interchangeably with pudendal nerve entrapment and Alcock Canal Syndrome, a 2009 study found pudendal neuralgia to be a “rare event” and “no evidence to support equating the presence of this syndrome with a diagnosis of pudendal nerve entrapment”. This means one might display all the symptoms of pudendal neuralgia but not actually have an entrapped (pinched) pundendal nerve. [7] Entrapment is just one possible cause.
Infrequency, however, does not change the fact that pudendal neuralgia is a debilitating and extremely uncomfortable condition. The agony can become so intense, individuals are unable to urinate, have intercourse, or even sit without experiencing intense, shooting, burning pain in the genitals and seat region.
A Pudendal Nerve block is a procedure using x-ray or ultrasound guidance to treat symptoms of genital, tailbone (coccyx), and/or rectal pain (pudendal neuralgia) by blocking the nerve impulses. Injecting the area around the pudendal nerve with a local anesthetic (lidocaine) and steroid will give immediate temporary relief of genital, rectal, and/or tailbone (coccyx) pain. Repeating the injections can eliminate or substantially reduce the pain in many patients.