Pudendal Nerve Block
(Image-Guided Relief for Chronic Pelvic and Perineal Pain)
Overview
The pudendal nerve supplies sensation to the perineum, genitals, anus, and surrounding pelvic floor structures. When irritated or compressed, it can lead to pudendal neuralgia, a chronic pain condition often described as burning, tingling, or sharp discomfort—especially when sitting.
A pudendal nerve block is a targeted, non-surgical injection used to diagnose and treat pudendal nerve-related pain. This procedure involves injecting a local anesthetic, sometimes with steroid, around the nerve to reduce inflammation and block pain signals.
At Restore Spine and Pain, we perform this injection using ultrasound or fluoroscopic (X-ray) guidance to ensure safety and accuracy
Conditions Treated
- Pudendal neuralgia
- Pelvic floor dysfunction
- Pain following pelvic trauma or childbirth
- Chronic perineal, vaginal, rectal, or scrotal pain
- Pain aggravated by prolonged sitting
What are the risks and side effects?
Risks and side effects are minimal, and serious complications are rare. We take every precaution to ensure your safety. Potential risks may include but are not limited to:
- Vasovagal reaction (fainting or dizziness)
- Temporary numbness in the genital or rectal area
- Increased pelvic discomfort
- Infection or bleeding at the injection site
- Allergic reaction to medications
- Elevated blood sugar in diabetic patients
Ask your provider if you have any concerns. Your physician will review the risks in detail before the procedure to ensure you are fully informed.
Pre-Procedure Information
How Should I Prepare?
- Driver Required: We ask that you arrange for a driver to take you home after the procedure.
- Food: You may eat a light meal 1–2 hours prior to the procedure. If sedation is planned, please follow the specific sedation protocol provided by our team.
Medications:
- Continue routine medications unless directed otherwise.
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Blood thinners, Aspirin, NSAIDs, and supplements:
- Inform us in advance if you take blood thinners (e.g., Plavix, Eliquis, Xarelto, Coumadin), NSAIDs (e.g., ibuprofen, naproxen), Aspirin, or supplements that increase bleeding risk.
- Certain medications may need to be stopped for a short period of time before the injection.
- Speak with your prescribing provider to ensure it’s safe to temporarily stop these medications
- Our team will review your medication list and coordinate with your other providers if needed.
Notify us if:
- You have a fever, infection, or are feeling unwell.
- You have started antibiotics or had changes to your medications
Sedation
Most cervical epidural steroid injections can be performed comfortably without sedation. However, if you have anxiety or difficulty lying flat, mild sedation may be offered at the discretion of the physician. Please discuss this with your provider in advance.
Special Instructions for Diabetic Patients:
Steroid injections may raise blood sugar levels for several days.
- Please contact your primary care physician or endocrinologist prior to the procedure for management recommendations.
- Monitor your glucose closely after the injection.
- Report sustained elevations to your managing provider.
What if I am pregnant?
There are serious potential risks to an unborn fetus from imaging used during this procedure (e.g., X-ray/fluoroscopy). If there is any chance you may be pregnant, please notify our team immediately and postpone the injection until pregnancy is ruled out.
Procedure Information
The procedure is performed using sterile technique under real-time X-ray (fluoroscopic) guidance.
What to Expect:
1. Preparation:
- You will be positioned on the procedure table.
- The skin will be cleaned and numbed with a local anesthetic.
2. Injection Process:
- A needle is directed near the affected nerve(s).
- Contrast dye may be used to confirm positioning.
- The injection may include local anesthetic and steroid, depending on the indication.
Monitoring:
- You will be monitored during the procedure to ensure comfort and safety.
- Most procedures last 10-15 minutes, followed by a brief recovery period on-site.
Post-Procedure Information
What to Expect After the Procedure
- Relief Timeline: Steroids typically begin to work within 2 to 5 days, but in some cases may take up to 2 weeks. You may experience temporary numbness or tingling in the pelvic region.
- Activity:You may resume light activities the next day; avoid strenuous activity for 24 hours. We recommend you return to work the following day.
- Soreness: Temporary soreness at the injection site is common.
- Pain tracking: Keep a log of symptoms over the next 1–2 weeks.
If successful, additional injections may be spaced out over time—typically no more than 3–4 per year in the same region.
Additional Instructions:
- Contact the office for any signs of infection, fever, or worsening pain.
- Attend follow-up as scheduled.
Schedule a Consultation
If you’re living with persistent pelvic or perineal pain, a pudendal nerve block may help identify and relieve the source of discomfort. Contact Restore Spine and Pain to schedule a consultation and learn more about this non-surgical treatment option.