Treatment information
Understanding your pathway
What is the treatment?
A pudendal nerve block places medication near a nerve supplying parts of the perineum and genital region. It may contribute to the assessment or management of selected pudendal pain presentations. Pudendal pain is one possible explanation for pelvic symptoms, not a diagnosis that can be made from painful sitting alone. [1][2]
Who may be considered?
Assessment considers the distribution of pain, examination and other pelvic conditions. A block may be discussed when it could answer a defined clinical question. Bowel, bladder, reproductive or other causes should be assessed as appropriate. Its role and uncertainty should be clear before treatment. [1][2]
Assessment, preparation and consent
Before deciding, discuss your diagnosis, previous treatment, medicines and relevant health conditions. Tell the clinician about allergies, infection, blood-thinning medicines, diabetes and possible pregnancy. Do not stop prescribed medicines yourself. Ask what alternatives are available, including not having a procedure, and allow time to consider the benefits, uncertainty and risks that matter to you. [3]
What happens during treatment?
The target and approach are discussed before the procedure, including whether imaging is used and which medicine is planned. A baseline record of pain and usual activities can help interpretation. The team explains expected temporary changes and any precautions for sitting, movement and returning to usual activities. [1][2]
Risks and safety considerations
Possible harms include soreness, bleeding, infection, allergy and temporary numbness or weakness. Nearby pelvic structures may be affected, so the clinician must explain approach-specific risks. New bladder or bowel dysfunction, worsening weakness or severe unexpected pain after treatment requires prompt medical review. [1][2]
Recovery and when to seek help
Follow the written instructions for transport, supervision, medicines, activity and driving. Recovery depends on the treatment and your health, so a fixed return-to-work date cannot be promised. Ask who to contact outside clinic hours. Seek urgent assessment for fever with worsening pain, new weakness or other unexpected neurological symptoms. Call 000 for breathing difficulty, collapse or another medical emergency. [4][3]
Expected benefit and limitations
A response may support an assessment but does not conclusively prove nerve entrapment or predict surgical success. Relief may be brief or absent. Pelvic-health rehabilitation, medication review and other care may remain relevant. Further intervention should depend on the complete clinical picture and your preferences. [1][2]
Follow-up and rehabilitation
Before treatment, choose a practical goal such as walking, sleep or a daily task. Record changes in that activity, pain and any adverse effects, then discuss them at follow-up. Ask what degree of change would justify further treatment and what would lead to stopping or changing the plan. Rehabilitation and self-management may remain part of care even if symptoms improve. [3][5]
Questions to bring to your appointment
Ask which structure is being targeted, why this approach is being considered and how strong the evidence is for your diagnosis. Clarify costs, the planned review date and any practical help you may need at home. Bring previous reports and your medicine list so the discussion can address your circumstances rather than a generic treatment pathway.
Sources and further reading
Sources support the statements cited above. Overseas guidance may describe different services or eligibility rules. A procedure leaflet explains a technique and its risks; it does not establish that the treatment is effective for every condition.
- Pudendal neuralgia — NHS
- Pelvic pain — NHS
- Procedures in pain medicine clinical care standard — Faculty of Pain Medicine, ANZCA
- Dorsal root ganglion / nerve root block / transforaminal injection — Hull University Teaching Hospitals NHS Trust
- Options for chronic pain management — Healthdirect Australia