A pudendal nerve block is used to diagnose and treat chronic pain in the pelvic region, perineum, genitals, and rectal area, particularly for pudendal neuralgia. This condition arises when the pudendal nerve becomes irritated or compressed, causing persistent pain, burning, or numbness.

During the procedure, you'll lie on your side or stomach, and the provider will use ultrasound or X-ray to guide a small needle near the pudendal nerve. A local anesthetic blocks pain signals, and sometimes, steroids or other medications are added to reduce inflammation and provide longer relief. The numbing effect starts immediately, lasting hours, while steroids can offer relieve for weeks or months, but may take days to feel the effects.

This procedure helps confirm if the pudendal nerve is the pain source. If relief is achieved, advanced treatments like radiofrequency ablation, peripheral nerve stimulation, Dorsal Root Ganglion stimulation, or Spinal Cord Stimulation may be considered for long-term control.

Other treatments include medications like gabapentin, pelvic floor physical therapy, or nerve-modulating injections to relax muscles and reduce nerve sensitivity. In severe cases, surgical decompression of the pudendal nerve may be explored.

Though generally safe, potential risks include temporary discomfort, numbness, or rare nerve irritation, bleeding, or infection.

After the injection, rest and avoid heavy activities for a day. Quick relief is common, and a follow-up is vital to evaluate the response and discuss further steps. If chronic pelvic pain affects your life, a pudendal nerve block might be the first step toward relief.