The Posterior Femoral Cutaneous Nerve…A Literal Pain in the A**

Nerves

Nerves are the information highways of your body.  There are 3 types of nerves: sensory nerves, which carry information from your 5 senses to your central nervous system, motor nerves, which are responsible for voluntary movements in your body, and mixed nerves, which, predictably enough, do both. 

Your sitting pain explained

Does your backside hurt even when you're sitting with good posture? Your buttock muscle, the glute max, covers the Posterior Femoral Cutaneous Nerve (PFCN) in most people during sitting, preventing it from giving you pain.  So, if you don’t have adequate musculature or padding around your sit bone, it becomes exposed and can become painful.  The PFCN is a sensory nerve which means that the only symptom you experience with disruption of this nerve is pain.  Often the pain associated with this nerve is near your sit bone when it is compressed so it’s literally a pain in your butt. 

This is a common issue for cyclists. If having your bike fitted, saddle custom fitted, and wearing padded shorts doesn’t relieve the pain, chances are your PFCN is irritated.  Having everything fitted will place your weight on your sit bones, where it should be, but if you have minimal gluteal muscles and no natural coverage and padding, your PFCN could be compressed.  

This nerve runs very close to the sciatic nerve and sometimes people mix them up. The PFCN runs from sacral nerve roots (tailbone area)  and travels just below the sciatic nerve as it exits the pelvis.  It is even sometimes referred to as the “lesser sciatic nerve.” It branches to the lower gluteal area, the perineum, and to the posterior thigh.  If the PFCN is irritated, you could experience pain anywhere along this nerve.  

Treating the Nerve

One treatment option that we highly recommend is percutaneous neuromodulation.  That means we use dry needles with electrical stimulation to decrease the nerve pain. 

More than that though, we have to identify the cause of the pain, which most of the time is limited gluteal muscle bulk, and address it to prevent pain from returning.  Gluteal strength training is often a great place to start.  

If you want to know more about dry needling and neuromodulation, check out our website!