Pelvic Floor Physical Therapy is Self-Reported as a Minimally Effective, and Sometimes Harmful, Treatment for Pudendal Neuralgia: A Cross-Sectional Study.

Objectives Pudendal neuralgia (PN) is a sexual pain disorder characterized as pain of the genital and/or perineal regions, and despite the lack of clinical evidence supporting its use, pelvic floor physical therapy (PFPT) is a recommended treatment for PN.

An online anonymous cross-sectional survey was administered to participants through convenience sampling conducted on May 19 to September 19, 2023 to understand the self-reported efficacy of PFPT as a treatment for PN. Participants’ measures included sociodemographics, Patient Global Impression of Change (PGIC), and satisfaction scores.

The average self-reported PGIC score among participants was 4.6 ± 1.3 (n = 144), indicating no to minimal improvement in symptoms. Most participants (66%) scored 4 or 5, suggesting no change to minimal improvement. Twelve percent of participants scored 3 or lower, indicating worsening of symptoms, and only 22% scored 6 or 7, indicating much or very much improvement of symptoms. Participants who only participated in PFPT (n = 24) had a lower PGIC score of 4.4 ± 1.3. For self-reported satisfaction with PFPT as a treatment for PN, participants self-reported a score of 4.9 ± 3.0, indicating slight dissatisfaction. For those who experienced symptom improvement, the median number of sessions before noticing improvement was five sessions.

Based on self-reported results, PFPT is a minimally effective, and sometimes harmful, treatment for PN. Patients should receive greater transparency regarding the lack of efficacy of PFPT and its potential harm. Authors’ contributions JN led the study design, methodology, data curation, and analysis. DS supported the study design and conceptualization. JN and DS wrote the manuscript, and LK, JN, and DS read, edited, and approved the final version. All authors declare no financial or nonfinancial interests or commercial associations that may be relevant to the submitted work.