Sustained pain reduction in pudendal neuralgia following multimodal non-invasive rehabilitation: A 24-month clinical case report

L. Yosifova, R. Sivkov
Scripta Scientifica Medica, Online First, 2026

Introduction: Pudendal neuralgia (PN) is a chronic neuropathic pain condition caused by irritation or injury of the pudendal nerve. Management includes behavioral measures, pharmacological therapy, physiotherapy, nerve blocks, and surgical interventions. Non-invasive physiotherapeutic modalities such as transcutaneous electrical nerve stimulation (TENS), low-frequency pulsed magnetic field (LFPMF) therapy, high-intensity laser therapy (MLS laser), and pelvic floor muscle training may contribute to pain reduction and functional improvement.

Aim: The aim of this article is to present a clinical case of PN treated with a comprehensive multimodal rehabilitation program.

Materials and Methods: A 48-year-old male with chronic pelvic pain underwent three 10-day rehabilitation courses at baseline, 6 months, and 12 months. Each course included LFPMF, TENS, high-intensity laser therapy, and pelvic floor muscle training, followed by home-based recommendations. Outcomes were assessed using the Short-Form McGill Pain Questionnaire (SF-MPQ-2) and physical examination at baseline, after each course, and at 24-month follow-up.

Results: Pain intensity decreased by 56% after the first course, 63% after the second, and 78% after the third. At 24 months, the patient reported only occasional mild discomfort without functional limitation.

Conclusion: Early recognition of PN is essential in patients with persistent pelvic pain. A multimodal, non-invasive rehabilitation approach combining LFPMF, TENS, high-intensity laser therapy, and pelvic floor muscle training may provide sustained pain relief and functional improvement. Further controlled studies are needed to confirm efficacy and standardize treatment protocols.