03/04/2026
Your patient is complaining of pain with sitting and generalized pelvic pain … your brain immediately goes to pudendal - but what else could it be?
Don’t sleep on the potential for it to be the posterior femoral cutaneous nerve of the thigh, ge***al branch!
The PFCN can mimic pudendal pain, sciatica and even SIJ referral. But its that ge***al branch that can be sneaky causing painful in*******se, irritation when wearing pants/underwear (mimicking vulvodynia) and even tailbone pain.
Clues that this nerve might be the culprit is history of hamstring issues/irritation/overuse esp proximally, and looking at the specific pain distribution to rule OUT more specific pain presentations of pudendal nerve pain. (💡To say it another way, true pudendal nerve pain will not have glute pain, gluteal fold pan, and/or posterior thigh irritation associated with it.)
Stats of the PFCN:
▶️ sensory nerve derived from the sacral plexus S1-3
▶️ three branches innervates skin of the posterior thigh, buttock, and posterior aspect of the sc***um or l***a (and calf)
▶️ along its path, it can be influenced by the piriformis, glute max, hamstrings (biceps femoris), adductors (gracilis), and gastroc
▶️ pain/irritation here can be confused by coccyx pain, sciatica, SIJ referral, pudendal nerve issues to name a few!
Save this for reference! Gimme a comment if this was helpful! ✨👍🏼
