{"id":8094,"date":"2026-02-05T10:53:28","date_gmt":"2026-02-05T09:53:28","guid":{"rendered":"https:\/\/blueportance.com\/referred-pain-trident\/"},"modified":"2026-10-25T22:43:34","modified_gmt":"2026-10-25T21:43:34","slug":"referred-pain-trident","status":"publish","type":"page","link":"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/referred-pain-trident\/","title":{"rendered":"KB_Pudendal Neuralgia_03 : Referred Pain and Pudendal Trident"},"content":{"rendered":"\n\n<style>\n  .bp-bdc-wrap {\n    max-width: 980px;\n    margin: 0 auto;\n    padding: 0 16px 48px;\n    color: #222;\n    line-height: 1.65;\n  }\n\n  .bp-bdc-breadcrumb {\n    max-width: 900px;\n    margin: 0 auto;\n    padding: 20px 16px 0;\n    font-size: .85rem;\n    color: #6b7280;\n  }\n\n  .bp-bdc-breadcrumb a {\n    color: #2a7fba;\n    text-decoration: none;\n  }\n\n  .bp-bdc-breadcrumb a:hover {\n    text-decoration: underline;\n  }\n\n  .bp-bdc-hero {\n    max-width: 900px;\n    margin: 30px auto 0;\n  }\n\n  .bp-bdc-hero h1 {\n    margin-bottom: 18px;\n    line-height: 1.2;\n  }\n\n  .bp-bdc-meta {\n    margin-top: 22px;\n    padding: 12px 16px;\n    background: #f4f8fb;\n    border-left: 4px solid #2a7fba;\n    color: #52606d;\n    font-size: .9rem;\n  }\n\n  .bp-bdc-toc {\n    max-width: 900px;\n    margin: 34px auto;\n    padding: 22px 26px;\n    background: #f7fafc;\n    border: 1px solid #e1e8ee;\n    border-radius: 10px;\n  }\n\n  .bp-bdc-toc h2 {\n    margin-top: 0;\n  }\n\n  .bp-bdc-toc a {\n    color: #1e73be;\n  }\n\n  .bp-bdc-content {\n    max-width: 900px;\n    margin: 0 auto;\n  }\n\n  .bp-bdc-content h2 {\n    margin-top: 48px;\n    padding-bottom: 8px;\n    border-bottom: 2px solid #d9e8f5;\n    line-height: 1.3;\n  }\n\n  .bp-bdc-content h3 {\n    margin-top: 32px;\n    line-height: 1.35;\n  }\n\n  .bp-bdc-content p {\n    margin: 0 0 18px;\n  }\n\n  .bp-bdc-content ul,\n  .bp-bdc-content ol {\n    margin-bottom: 22px;\n  }\n\n  .bp-bdc-content li {\n    margin-bottom: 10px;\n  }\n\n  .bp-bdc-box {\n    margin: 26px 0;\n    padding: 20px 24px;\n    border-radius: 10px;\n  }\n\n  .bp-bdc-box--soft {\n    background: #f4f8fb;\n    border: 1px solid #d9e8f5;\n  }\n\n  .bp-bdc-box--warning {\n    background: #fff8ed;\n    border-left: 4px solid #f39c12;\n  }\n\n  .bp-figure {\n    margin: 30px auto;\n    padding: 0;\n    text-align: center;\n  }\n\n  .bp-figure img {\n    display: block;\n    width: 100%;\n    max-width: 900px;\n    height: auto;\n    margin: 0 auto;\n  }\n\n  .bp-figure figcaption {\n    margin-top: 12px;\n    color: #59636e;\n    font-size: .92rem;\n    text-align: left;\n  }\n\n  .bp-bdc-navigation {\n    margin-top: 44px;\n    padding: 22px 24px;\n    background: #f7fafc;\n    border: 1px solid #e1e8ee;\n    border-radius: 10px;\n  }\n\n  .bp-bdc-navigation a {\n    color: #1e73be;\n  }\n\n  .bp-bdc-footer {\n    margin-top: 28px;\n    padding: 18px 20px;\n    background: #fff8ed;\n    border-left: 4px solid #f39c12;\n    font-size: .92rem;\n  }\n\n  .bp-bdc-copyright {\n    font-size: .85em;\n    color: #6b7280;\n    margin-top: 22px;\n  }\n\n  .bp-reference-note {\n    color: #59636e;\n    font-size: .9rem;\n  }\n\n  .bp-bdc-level {\n    display: inline-block;\n    margin: 0 6px 6px 0;\n    padding: 3px 8px;\n    border-radius: 999px;\n    background: #eaf3f9;\n    color: #245f85;\n    font-size: .78rem;\n    font-weight: 700;\n    letter-spacing: .02em;\n  }\n\n  @media (max-width: 700px) {\n    .bp-bdc-wrap {\n      padding-left: 12px;\n      padding-right: 12px;\n    }\n\n    .bp-bdc-box {\n      padding: 18px;\n    }\n  }\n<\/style>\n\n<nav class=\"bp-bdc-breadcrumb\" aria-label=\"Breadcrumb\">\n<a href=\"\/en\/\">Blue Portance<\/a> \u2192 <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/\">Knowledge Base<\/a> \u2192 <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/\">Sitting-Related Pain<\/a> \u2192 <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/\">Pudendal Neuralgia<\/a> \u2192 Referred Pain and the Pudendal Trident\n<\/nav>\n\n<section class=\"bp-bdc-wrap\">\n\n  <header class=\"bp-bdc-hero\">\n\n    <h1>\n      Referred Pain and the Pudendal Trident:\n      Understanding Symptom Territories\n    <\/h1>\n\n    <p>\n      In pudendal neuralgia, the area where pain is felt does not always allow\n      clinicians to identify precisely the structure responsible. Perineal, anal,\n      or genital pain may be linked to irritation of the pudendal nerve or of\n      one of its branches, but it may also have other local, muscular, visceral,\n      or neurological origins.\n    <\/p>\n\n    <p>\n      The notion of referred pain must therefore be used with caution. It\n      describes a possible mismatch between the site where pain is perceived and\n      the site of a nerve irritation, without allowing one to automatically\n      conclude that there is an entrapment located along the course of the pudendal\n      nerve. This distinction is important to avoid reducing every perineal\n      symptom to a single anatomical cause.\n    <\/p>\n\n    <p>\n      Used as a functional map, the \u201cpudendal trident\u201d nevertheless retains major\n      value: it allows clinicians to examine whether several apparently distinct\n      areas belong to connected nerve territories, whether their symptoms change\n      together, and whether the same mechanical context modulates them. It guides\n      reasoning without, on its own, identifying the cause or the level of any\n      possible nerve involvement.\n    <\/p>\n\n    <div class=\"bp-bdc-meta\">\n      Blue Portance Knowledge Base \u00b7 Non-commercial reproduction permitted with\n      citation of the source\n    <\/div>\n\n  <\/header>\n\n  <nav class=\"bp-bdc-toc\" aria-label=\"Table of contents\">\n\n    <h2>Table of Contents<\/h2>\n\n    <ul>\n      <li>\n        <a href=\"#projection\">\n          1. Distributed pain and referred pain\n        <\/a>\n      <\/li>\n\n      <li>\n        <a href=\"#trident\">\n          2. The branches of the pudendal nerve\n        <\/a>\n      <\/li>\n\n      <li>\n        <a href=\"#tableaux\">\n          3. Clinical presentations and differential diagnoses\n        <\/a>\n      <\/li>\n\n      <li>\n        <a href=\"#errance\">\n          4. Why the diagnostic journey can be long\n        <\/a>\n      <\/li>\n\n      <li>\n        <a href=\"#references\">\n          Scientific references\n        <\/a>\n      <\/li>\n    <\/ul>\n\n  <\/nav>\n\n  <article class=\"bp-bdc-content\">\n\n    <section id=\"projection\">\n\n      <h2>1. Distributed pain and referred pain<\/h2>\n\n      <p>\n        <span class=\"bp-bdc-level\">ESTABLISHED NEUROANATOMY<\/span>\n        <span class=\"bp-bdc-level\">FUNCTIONAL INTERPRETATION<\/span>\n      <\/p>\n\n      <p>\n        The pudendal nerve carries sensory information from several regions of\n        the perineum, the anal region, and the external genitalia. Irritation of\n        the nerve or of one of its branches can therefore produce pain in a\n        territory corresponding to this innervation.\n      <\/p>\n\n      <p>\n        It is nevertheless useful to distinguish between two situations. The\n        first is distributed pain: the symptom is perceived in the peripheral\n        territory of the irritated nerve. The second is referred pain in the\n        stricter sense: the pain is felt in an area that does not correspond\n        exactly to the site of stimulation or irritation.\n      <\/p>\n\n      <p>\n        In clinical practice, these two notions are sometimes used\n        interchangeably. Yet pain located in the urethral, vulvar, penile, anal,\n        or rectal region is not, on its own, enough to determine\n        whether the pudendal nerve is involved, or to localize the level of any\n        such involvement.\n      <\/p>\n\n      <p>\n        The distinction therefore does not cancel out the informative value of the\n        territory. Distributed pain can link a distal perception to the branch that\n        transmits the signal; referred pain or overlapping territories can make this\n        relationship less direct. In both cases, the symptom map is a clue to be\n        weighed against the other data, not topographic proof.\n      <\/p>\n\n      <p>\n        Symptoms must be weighed against how they change over time, their\n        relationship to sitting, the clinical examination, any neurological\n        signs, and possible local or visceral causes. The Nantes criteria can\n        contribute to the assessment of pudendal neuralgia, but they do not\n        replace differential reasoning\n        (Labat et al., 2008).\n      <\/p>\n\n      <div class=\"bp-bdc-box bp-bdc-box--soft\">\n\n        <strong>Key point<\/strong>\n\n        <p>\n          The location of pain <strong>informs without localizing on its\n          own<\/strong>: it provides information about the pain distribution and\n          about the pathways likely to transmit the signal, but it is not enough to\n          identify the structure responsible or the precise site of any nerve\n          irritation.\n        <\/p>\n\n      <\/div>\n\n    <\/section>\n\n    <section id=\"trident\">\n\n      <h2>2. The branches of the pudendal nerve<\/h2>\n\n      <p>\n        <span class=\"bp-bdc-level\">ESTABLISHED ANATOMY<\/span>\n        <span class=\"bp-bdc-level\">TEACHING MAP<\/span>\n      <\/p>\n\n      <p>\n        The classic description of the pudendal nerve includes three main groups\n        of branches: the inferior rectal nerve, the perineal nerve, and the dorsal\n        nerve of the penis or clitoris. This presentation is useful for teaching\n        purposes, but it must be qualified: the origin, course, and level of\n        division of certain branches can vary between\n        individuals\n        (Robert et al., 1998; Zapletal et al., 2024).\n      <\/p>\n\n      <p>\n        The common course and the origin of these branches are detailed in\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/pudendal-nerve-anatomy\/\">\n          Functional Anatomy and Neuromechanics of the Pudendal Nerve\n        <\/a>.\n      <\/p>\n\n      <p>\n        The trident therefore does not represent three completely separate lines.\n        It schematizes three main terminal groups arising from a common course, with\n        anatomical variations and overlaps. Its functional value lies precisely in\n        this dual reading: distinguishing the dominant territories while looking for\n        what may connect them upstream.\n      <\/p>\n\n      <figure class=\"bp-figure\">\n\n        <img decoding=\"async\"\n          src=\"https:\/\/blueportance.com\/wp-content\/uploads\/IMG_NP_Terminal-branches_Pudendal-nerve.jpg\"\n          alt=\"Main branches of the pudendal nerve: inferior rectal nerve, perineal nerve, and dorsal nerve of the penis or clitoris\"\n          loading=\"lazy\">\n\n        <figcaption>\n          <strong>\n            Main branches of the pudendal nerve.\n          <\/strong>\n          The \u201ctrident\u201d depiction is a teaching simplification of the main\n          pudendal branches. It does not reflect all anatomical variations or all\n          overlaps between sensory\n          territories\n          (Robert et al., 1998; Zapletal et al., 2024).\n        <\/figcaption>\n\n      <\/figure>\n\n      <h3>2.1 Inferior rectal nerve<\/h3>\n\n      <p>\n        The inferior rectal nerve generally crosses the ischioanal fossa to\n        reach the anal region. It contributes to the motor innervation of the\n        external anal sphincter and to the sensation of the lower part of the\n        anal canal and the perianal region.\n      <\/p>\n\n      <p>\n        Its origin is variable: it can branch off from the pudendal nerve at\n        different levels, before or within the pudendal canal. Anal or perianal\n        pain may therefore be compatible with involvement of this branch, but it\n        may also stem from a local anorectal or muscular cause, or from another\n        nerve\n        (Robert et al., 1998; Zapletal et al., 2024).\n      <\/p>\n\n      <h3>2.2 Perineal nerve<\/h3>\n\n      <p>\n        The perineal nerve has superficial and deep branches. It contributes to\n        the sensory innervation of the skin of the perineum and of the scrotum\n        or labia majora, as well as to the motor innervation of several\n        perineal muscles and of the external urethral sphincter.\n      <\/p>\n\n      <p>\n        Perineal, vulvar, scrotal, or urethral pain may therefore lie within a\n        territory compatible with this branch. However, a urinary or genital\n        symptom should not be automatically attributed to the pudendal nerve:\n        an infection, inflammation, a dermatological condition, myofascial pain,\n        or another neuropathy must also be\n        considered.\n      <\/p>\n\n      <h3>2.3 Dorsal nerve of the penis or clitoris<\/h3>\n\n      <p>\n        The dorsal nerve of the penis or clitoris is a predominantly sensory\n        branch. It contributes to the sensation of the external genitalia and to\n        the transmission of information related to touch, pressure, and sexual\n        stimulation.\n      <\/p>\n\n      <p>\n        Hypersensitivity, allodynia, or pain on contact in the genital region\n        may be compatible with pudendal involvement. It may also correspond to a\n        local condition, vulvodynia, myofascial pain, or another nerve\n        disorder\n        (Aoun et al., 2021).\n      <\/p>\n\n      <p>\n        Sexual function results from the interaction of several somatic and\n        autonomic pathways. It would therefore be incorrect to attribute the\n        entire sexual response to the pudendal nerve alone\n        (Aoun et al., 2021).\n      <\/p>\n\n      <div class=\"bp-bdc-box bp-bdc-box--soft\">\n\n        <strong>How to read the trident without overinterpreting it<\/strong>\n\n        <ul>\n          <li>\n            A symptom that dominates in a single territory may direct attention\n            toward a terminal branch, but does not demonstrate that the branch is involved.\n          <\/li>\n          <li>\n            Symptoms affecting several pudendal territories and changing in a\n            synchronized way may lead to examining a common mechanism located\n            further upstream, or a broader functional interaction.\n          <\/li>\n          <li>\n            Symptoms that are scattered, not synchronized, or extend well beyond\n            the pudendal territories call for broadening the reasoning further to\n            local, myofascial, or visceral causes, or to other nerve pathways.\n          <\/li>\n        <\/ul>\n\n        <p>\n          These configurations are guides for reasoning. None of them constitutes\n          a localization rule or a validated diagnostic criterion.\n        <\/p>\n\n      <\/div>\n\n    <\/section>\n\n    <section id=\"tableaux\">\n\n      <h2>\n        3. Clinical presentations and differential diagnoses\n      <\/h2>\n\n      <p>\n        <span class=\"bp-bdc-level\">CONVERGING CLUES<\/span>\n      <\/p>\n\n      <p>\n        Pain located in a pudendal territory can take very diverse forms:\n        burning, electric-shock sensations, pain on pressure, hypersensitivity,\n        numbness, or deep discomfort. Its neuropathic character must, however,\n        be assessed clinically and cannot be inferred solely from the words the\n        patient uses.\n      <\/p>\n\n      <p>\n        In an SBNFA\u2122 reading, the analysis does not focus only on the location and\n        quality of the pain. It also looks for the <strong>covariation<\/strong>\n        of symptoms: do they appear together, do they increase after the same\n        length of time sitting, do they decrease with the same changes in weight\n        bearing, or do they behave independently? A shared pattern of change\n        strengthens the plausibility of a shared mechanism, without determining\n        its nature.\n      <\/p>\n\n      <h3>3.1 Urinary or urethral symptoms<\/h3>\n\n      <p>\n        Urethral burning or discomfort felt during or after urination may lie\n        within a territory compatible with the perineal branches. However, a\n        urinary tract infection, inflammation, mucosal irritation, bladder pain,\n        or another urological cause must be looked for before suggesting an\n        exclusively nerve-related origin.\n      <\/p>\n\n      <h3>3.2 Anal or rectal pain<\/h3>\n\n      <p>\n        Anal or rectal pain may be associated with the territory of the inferior\n        rectal nerve. It may also correspond to a fissure, hemorrhoidal disease,\n        inflammation, functional anorectal pain, a muscular disorder, or another\n        local cause.\n      <\/p>\n\n      <h3>3.3 Genital pain<\/h3>\n\n      <p>\n        Vulvar, clitoral, penile, or scrotal pain may stem from irritation of\n        pudendal branches, but also from a dermatological, infectious,\n        inflammatory, or myofascial condition, or from another neuropathy. A\n        normal local examination therefore does not, on its own, prove a\n        pudendal origin.\n      <\/p>\n\n      <div class=\"bp-bdc-box bp-bdc-box--soft\">\n\n        <strong>Takeaway<\/strong>\n\n        <p>\n          A normal local examination does not mean that the pain is imaginary.\n          It means that no obvious local cause was identified by the examination\n          performed. The pain may then require a neurological, musculoskeletal,\n          urological, gynecological, or proctological evaluation, depending on\n          the clinical picture.\n        <\/p>\n\n      <\/div>\n\n    <\/section>\n\n    <section id=\"errance\">\n\n      <h2>\n        4. Why the diagnostic journey can be long\n      <\/h2>\n\n      <p>\n        <span class=\"bp-bdc-level\">FUNCTIONAL SYNTHESIS<\/span>\n      <\/p>\n\n      <p>\n        Perineal symptoms sit at the interface of several disciplines: urology,\n        gynecology, proctology, dermatology, neurology, pain medicine, and\n        pelvic floor rehabilitation.\n      <\/p>\n\n      <p>\n        This diversity can complicate the journey when each symptom is analyzed\n        solely on the basis of the organ in which it is felt. Conversely,\n        attributing symptoms too quickly to the pudendal nerve can also lead to\n        overlooking a local cause or another neuropathy.\n      <\/p>\n\n      <p>\n        Two opposite forms of fragmentation are therefore possible: treating the\n        urethra, the anus, and the genitalia separately even though their symptoms\n        follow a common dynamic; or, conversely, grouping all pelvic and perineal\n        pain too quickly under the pudendal label. The trident is useful when it\n        allows clinicians to test the overall coherence without erasing the\n        differential diagnoses specific to each territory.\n      <\/p>\n\n      <p>\n        Pudendal neuralgia is primarily a clinical diagnosis. There is no single\n        test that can confirm every case, and several differential diagnoses\n        must be considered before retaining this\n        hypothesis\n        (Labat et al., 2008; Fu\u010d\u00edk &amp; Ma\u0161ata, 2021).\n      <\/p>\n\n      <p>\n        The goal, therefore, is not to choose simplistically between an\n        \u201corganic\u201d origin and a \u201cnerve\u201d origin. It involves relating the\n        pain distribution, the time profile, sitting, the associated signs,\n        the clinical examination, and the results of appropriate\n        diagnostic testing.\n      <\/p>\n\n      <p>\n        A step-by-step reading can then be organized around four\n        questions:\n      <\/p>\n\n      <ol>\n        <li>\n          Which territories are involved, and which local causes should be\n          looked for?\n        <\/li>\n        <li>\n          Do the symptoms in several territories change together?\n        <\/li>\n        <li>\n          Does their onset depend on posture, the length of time sitting, weight\n          bearing, or recovery?\n        <\/li>\n        <li>\n          Does the picture correspond more closely to a terminal branch, to a\n          more proximal common mechanism, to a mixed mechanism, or to another\n          origin?\n        <\/li>\n      <\/ol>\n\n      <p>\n        This sequence does not localize a lesion. It prevents the plurality of\n        painful sites from being mistaken for a necessary plurality of causes, and\n        it helps build a coherent hypothesis to be reassessed against\n        the clinical data.\n      <\/p>\n\n      <p>\n        This approach also allows clinicians to acknowledge the reality of the pain\n        when local examinations are reassuring, without asserting that a pudendal\n        mechanism is necessarily present.\n      <\/p>\n\n      <p>\n        The possible consequences of a prolonged diagnostic journey are explored in\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/wandering-central-sensitization\/\">\n          The Diagnostic Odyssey and Central Sensitization in Pudendal Neuralgia\n        <\/a>.\n      <\/p>\n\n    <\/section>\n\n    <section id=\"references\">\n\n      <h2>Scientific references<\/h2>\n\n      <div class=\"bp-bdc-box bp-bdc-box--soft\">\n\n        <ol>\n\n          <li>\n            <strong>\n              Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Rigaud J.\n            <\/strong>\n            Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment\n            (Nantes criteria).\n            <em>Neurourology and Urodynamics<\/em>.\n            2008;27(4):306\u2013310.\n            DOI:\n            <a\n              href=\"https:\/\/doi.org\/10.1002\/nau.20505\"\n              target=\"_blank\"\n              rel=\"noopener\">\n              10.1002\/nau.20505\n            <\/a>.\n            <br>\n            <a\n              href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17828787\/\"\n              target=\"_blank\"\n              rel=\"noopener\">\n              View PubMed record\n            <\/a>\n          <\/li>\n\n          <li>\n            <strong>\n              Robert R, Prat-Pradal D, Labat JJ, Bensignor M, Raoul S, Rebai R,\n              Leborgne J.\n            <\/strong>\n            Anatomic basis of chronic perineal pain: role of the pudendal nerve.\n            <em>Surgical and Radiologic Anatomy<\/em>.\n            1998;20(2):93\u201398.\n            DOI:\n            <a\n              href=\"https:\/\/doi.org\/10.1007\/BF01628908\"\n              target=\"_blank\"\n              rel=\"noopener\">\n              10.1007\/BF01628908\n            <\/a>.\n            <br>\n            <a\n              href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9658526\/\"\n              target=\"_blank\"\n              rel=\"noopener\">\n              View PubMed record\n            <\/a>\n          <\/li>\n\n          <li>\n            <strong>\n              Zapletal J, Nanka O, Halaska MJ, Maxova K, Hajkova Hympanova L,\n              Krofta L, et al.\n            <\/strong>\n            Anatomy of the pudendal nerve in clinically important areas:\n            a pictorial essay and narrative review.\n            <em>Surgical and Radiologic Anatomy<\/em>.\n            2024;46(2):211\u2013222.\n            DOI:\n            <a\n              href=\"https:\/\/doi.org\/10.1007\/s00276-023-03285-7\"\n              target=\"_blank\"\n              rel=\"noopener\">\n              10.1007\/s00276-023-03285-7\n            <\/a>.\n            <br>\n            <a\n              href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38240796\/\"\n              target=\"_blank\"\n              rel=\"noopener\">\n              View PubMed record\n            <\/a>\n          <\/li>\n\n          <li>\n            <strong>\n              Aoun F, Alkassis M, Abi Tayeh G, Chebel JA, Semaan A, Sarkis J,\n              et al.\n            <\/strong>\n            Sexual dysfunction due to pudendal neuralgia:\n            a systematic review.\n            <em>Translational Andrology and Urology<\/em>.\n            2021;10(6):2500\u20132511.\n            DOI:\n            <a\n              href=\"https:\/\/doi.org\/10.21037\/tau-21-13\"\n              target=\"_blank\"\n              rel=\"noopener\">\n              10.21037\/tau-21-13\n            <\/a>.\n            <br>\n            <a\n              href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34295736\/\"\n              target=\"_blank\"\n              rel=\"noopener\">\n              View PubMed record\n            <\/a>\n          <\/li>\n\n          <li>\n            <strong>\n              Fu\u010d\u00edk T, Ma\u0161ata J.\n            <\/strong>\n            Pelvic neuropathic pain (differential diagnosis).\n            <em>\u010cesk\u00e1 gynekologie<\/em>.\n            2021;86(4):279\u2013283. DOI: 10.48095\/cccg2021279.\n            <br>\n            <a\n              href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34493054\/\"\n              target=\"_blank\"\n              rel=\"noopener\">\n              View PubMed record\n            <\/a>\n          <\/li>\n\n        <\/ol>\n\n        <p class=\"bp-reference-note\">\n          These references document the anatomy of the pudendal nerve, its branches,\n          the clinical criteria for pudendal neuralgia, and the need for a\n          differential diagnosis. They do not demonstrate that all urinary,\n          rectal, or genital pain without a local lesion is necessarily of\n          pudendal origin.\n        <\/p>\n\n      <\/div>\n\n      <div class=\"bp-bdc-box bp-bdc-box--warning\">\n\n        <strong>Blue Portance internal reference<\/strong>\n\n        <p>\n          The SBNFA\u2122 framework can be used as a functional interpretive framework for\n          the relationship between the pain distribution, the nerve pathway, and\n          the diagnostic journey. It does not constitute a validated medical\n          classification.\n        <\/p>\n\n        <p>\n          Proposed internal reference:\n        <\/p>\n\n        <ul>\n          <li>\n            Blue Portance. Mod\u00e8le SBNFA\u2122 \u2014\n            <em>\n              Neuro-anatomie, partie III :\n              douleur distribu\u00e9e, douleur projet\u00e9e et parcours diagnostique\n            <\/em>\n            [SBNFA\u2122 Framework \u2014 Neuroanatomy, Part III: Distributed Pain, Referred Pain,\n            and the Diagnostic Journey].\n            2026.\n          <\/li>\n        <\/ul>\n\n      <\/div>\n\n    <\/section>\n\n    <div class=\"bp-bdc-navigation\">\n      <strong>Pudendal Neuralgia Pathway<\/strong>\n      <p>\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/pudendal-nerve-anatomy\/\">1. Functional Anatomy and Neuromechanics of the Pudendal Nerve<\/a><br>\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/mechanical-locks\/\">2. Mechanical Vulnerability and Pudendal Nerve Entrapment Mechanisms<\/a><br>\n        <strong>3. Referred Pain and the Pudendal Trident: Understanding Symptom Territories<\/strong><br>\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/structural-functional-triage\/\">4. SBNFA\u2122 Triage: Distinguishing Structural Factors from Functional Mechanisms<\/a><br>\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/fascia-neural-gliding\/\">5. Fascia, Nerve Gliding, and Tissue Densification<\/a><br>\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/wandering-central-sensitization\/\">6. The Diagnostic Odyssey and Central Sensitization in Pudendal Neuralgia<\/a>\n      <\/p>\n      <p>\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/mechanical-locks\/\">\u2190 Previous article<\/a> \u00b7\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/structural-functional-triage\/\">Next article \u2192<\/a>\n      <\/p>\n    <\/div>\n\n    <div class=\"bp-bdc-navigation\">\n\n      <strong>Navigation<\/strong>\n\n      <p>\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/pudendal-neuralgia\/\">\n          \u2190 Back to the Pudendal Neuralgia hub\n        <\/a>\n        <br>\n\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/expert-guides\/sitting-related-pain\/\">\n          \u2190 See the topic: Sitting-Related Pain\n        <\/a>\n        <br>\n\n        <a href=\"https:\/\/blueportance.com\/en\/knowledge-base\/\">\n          \u2190 Explore the Knowledge Base\n        <\/a>\n      <\/p>\n\n    <\/div>\n\n    <footer class=\"bp-bdc-footer\">\n\n      <strong>Note:<\/strong>\n      this content aims to present anatomical, clinical, and functional\n      information on perineal pain and pudendal neuralgia. It constitutes\n      neither a medical diagnosis, nor a therapeutic recommendation, nor proof\n      that pain localized in a pudendal territory is necessarily due to\n      involvement of this nerve.\n\n    <\/footer>\n\n    <p class=\"bp-bdc-copyright\">\n      \u00a9 Gil Ayache. The concepts, diagrams, terminology, and principles presented on this page constitute a work protected by copyright. They are made available to Blue Portance under an intellectual property license agreement, without transfer of economic rights or of authorship.\n    <\/p>\n\n  <\/article>\n\n<\/section>\n\n\n","protected":false},"excerpt":{"rendered":"<p>Blue Portance \u2192 Knowledge Base \u2192 Sitting-Related Pain \u2192 Pudendal Neuralgia \u2192 Referred Pain and the Pudendal Trident Referred Pain and the Pudendal Trident: Understanding Symptom Territories In pudendal neuralgia, the area where pain is felt does not always allow clinicians to identify precisely the structure responsible. Perineal, anal, or genital pain may be linked [&#8230;]\n","protected":false},"author":6,"featured_media":0,"parent":8099,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_yoast_wpseo_title":"Pudendal Referred Pain: The Pudendal Trident | Blue Portance","_yoast_wpseo_metadesc":"Referred pain in pudendal neuralgia explained through the pudendal trident and its rectal, perineal, and genital branches.","footnotes":""},"pathologie_secondaire":[],"effet_positif":[],"class_list":["post-8094","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Pudendal Referred Pain: The Pudendal Trident | Blue Portance<\/title>\n<meta name=\"description\" content=\"Referred pain in pudendal neuralgia explained through the pudendal trident and its rectal, perineal, and genital 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