Sleeping Positions for Pudendal Nerve Health: Tips and Best Practices

By Dr. Zarina Vitebsky, DPT, MSPT, PRPC, TPS, LPF, DN on 10/20/2023

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Explanation of the Pudendal Nerve

The pudendal nerve is a major nerve located in the pelvic region that plays a crucial role in controlling the muscles of the bladder, bowel, and genitals. It also provides sensation to the perineum, which is the area between the anus and genitals.

Importance of Proper Sleeping Position for Pudendal Nerve Health

The pudendal nerve can become compressed or irritated if the body is in an improper sleeping position, leading to symptoms such as pain, numbness, and tingling in the pelvic region. This can also affect bladder and bowel function, as well as sexual function.

Anatomy of the Pudendal Nerve

Location and Function of the Pudendal Nerve

The pudendal nerve is a major nerve in the pelvic region that originates from the sacral plexus, a network of nerves located in the lower back. It travels through the pelvis and branches out to innervate the perineum, which includes the genitals, anus, and surrounding muscles.

The main function of the pudendal nerve is to provide sensation to the perineum and control the muscles involved in sexual function and bladder control. It also plays a role in bowel movements and the sensation of pain in the pelvic region.

Role in Sexual Function and Bladder Control

The pudendal nerve is crucial for sexual function as it supplies sensation to the genitals and controls the muscles involved in sexual arousal and orgasm. It also plays a role in bladder control by innervating the muscles that help with urination and maintaining continence.

In men, the pudendal nerve is responsible for the sensation and control of the penis, scrotum, and anus. In women, it innervates the clitoris, labia, and anus. Dysfunction of the pudendal nerve can lead to sexual dysfunction and urinary incontinence.

Common Issues Related to Pudendal Nerve Dysfunction

Pudendal nerve dysfunction can be caused by various factors such as injury, compression, or inflammation of the nerve. This can result in symptoms such as pain, numbness, and tingling in the perineum, as well as sexual dysfunction and bladder control issues.

Some common conditions related to pudendal nerve dysfunction include pudendal neuralgia, which is characterized by chronic pelvic pain, and pelvic floor dysfunction, which can lead to urinary and bowel problems. These conditions can greatly impact a person's quality of life and may require medical treatment.

Effects of Sleeping Position on the Pudendal Nerve

Pressure and Compression on the Nerve

The pudendal nerve is a major nerve that runs through the pelvic region and is responsible for sensation and motor function in the genitals, anus, and perineum. When we sleep, our bodies naturally shift and change positions, which can put pressure and compression on the pudendal nerve. This can occur if we sleep on our back, stomach, or side, depending on the position of our legs and hips. This pressure and compression can lead to irritation and inflammation of the nerve, causing symptoms such as pain, numbness, and tingling in the pelvic region.

Impact on Nerve Function and Symptoms

The pudendal nerve is crucial for normal bladder, bowel, and sexual function. When it is compressed or irritated during sleep, it can lead to dysfunction in these areas. For example, pressure on the nerve can cause urinary urgency, frequency, and incontinence. It can also contribute to constipation and difficulty with bowel movements. In terms of sexual function, compression of the pudendal nerve can lead to decreased sensation and arousal, as well as pain during intercourse. These symptoms can significantly impact a person's quality of life and overall well-being.

Connection to Pelvic Floor Muscles and Posture

The pudendal nerve is closely connected to the pelvic floor muscles, which play a crucial role in supporting the pelvic organs and maintaining continence. When the nerve is compressed during sleep, it can also put pressure on the pelvic floor muscles, leading to tension and dysfunction. This can contribute to pelvic pain, incontinence, and other symptoms. Additionally, our sleeping posture can also affect the alignment and tension of our pelvic floor muscles. For example, sleeping on our stomach can cause the pelvic floor to be in a shortened and contracted position, while sleeping on our back can lead to a lengthened and relaxed position. Both of these can impact the function of the pelvic floor and the pudendal nerve.

Best Sleeping Positions for Pudendal Nerve Health

Recommended positions for reducing pressure on the nerve

The pudendal nerve is a major nerve in the pelvic region that can become compressed or irritated due to certain sleeping positions. To avoid this, it is recommended to sleep on your side with a pillow between your knees. This position helps to keep your spine aligned and reduces pressure on the nerve.

Importance of proper alignment and support

Proper alignment and support are crucial for maintaining the health of the pudendal nerve while sleeping. When your body is properly aligned, there is less strain on the nerve and surrounding muscles. It is important to choose a mattress and pillow that provide adequate support for your body and promote proper alignment.

Tips for adjusting sleeping position

If you are used to sleeping on your back or stomach, it may take some time to adjust to sleeping on your side. To make the transition easier, try using a body pillow to support your back and keep you from rolling onto your stomach. You can also experiment with different pillow placements to find the most comfortable position for your body.

Other Factors to Consider

Mattress and Pillow Selection

When it comes to managing pudendal nerve pain, the type of mattress and pillow you use can make a big difference. A mattress that is too firm or too soft can put pressure on the pelvic area and aggravate symptoms. It is recommended to choose a medium-firm mattress that provides support without being too hard. Additionally, using a pillow that supports the natural curve of your spine can help alleviate pressure on the pelvic area while sleeping.

Impact of Clothing and Bedding Materials

The type of clothing and bedding materials you use can also have an impact on pudendal nerve pain. Tight clothing, especially around the waist and pelvic area, can compress the nerve and worsen symptoms. It is best to wear loose, comfortable clothing made from breathable materials. When it comes to bedding, avoid materials that can cause irritation or allergies, such as synthetic fabrics or harsh detergents. Opt for soft, natural materials like cotton or bamboo.

Importance of Regular Movement and Stretching

Sleeping in the same position for extended periods of time can put pressure on the pudendal nerve and lead to discomfort. It is important to incorporate regular movement and stretching into your daily routine, especially before going to bed. This can help improve circulation and prevent stiffness in the pelvic area. Simple stretches such as pelvic tilts, hip rotations, and butterfly stretches can be beneficial for managing pudendal nerve pain while sleeping.

Additional Tips for Pudendal Nerve Health

Pelvic Floor Exercises and Physical Therapy

The pudendal nerve is responsible for controlling the muscles in the pelvic floor, which play a crucial role in bladder and bowel control, sexual function, and overall pelvic stability. Regular pelvic floor exercises, also known as Kegels, can help strengthen these muscles and improve pudendal nerve function. Physical therapy can also be beneficial for those experiencing pudendal nerve issues, as a trained therapist can provide specific exercises and techniques to target the affected area.

Dietary and Lifestyle Changes

In addition to exercise, making certain dietary and lifestyle changes can also support pudendal nerve health. Eating a balanced diet with plenty of fiber can help prevent constipation, which can put pressure on the pudendal nerve. Avoiding foods and drinks that irritate the bladder, such as caffeine and alcohol, can also help reduce symptoms. Additionally, practicing good posture and avoiding prolonged sitting can alleviate pressure on the pelvic floor and pudendal nerve.

When to Seek Medical Help for Pudendal Nerve Issues

If pelvic pain, urinary or bowel dysfunction, or sexual dysfunction persist despite lifestyle changes and exercises, it may be time to seek medical help. A pelvic floor physical therapist can perform a consultation to determine the cause of the symptoms. It is important to address pudendal nerve issues early on to prevent further complications and improve overall quality of life.

If you are experiencing pelvic floor dysfunctions related to pudendal neuralgia, please reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at

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