A rare and late presentation of pudendal neuralgia in a patient with fibromyalgia after pilates exercises

A 32-year-old female patient was admitted to our clinic about two years ago with complaints of widespread pain, tiredness, fatigue, and insomnia for six months. She was diagnosed with fibromyalgia and initiated medical treatment with the recommendation of aerobic exercises. Her medical history revealed widespread pain disappeared one month after exercising with localized pelvic pain. She had also pain and burning sensation while sitting and lying down. She suffered from severe pain during defecation. Based on her medical history and physical examination findings, the patient was diagnosed with pudendal neuralgia. The patient was put on medical treatment and, then, referred to the anesthesia department due to persistent pain. Computed tomography-guided transgluteal pudendal nerve block was applied by the anesthesiologist. Subsequently, pain disappeared. In conclusion, pudendal neuralgia should be considered in the differential diagnosis in patients with pelvic pain and burning sensation or following compelling exercises.