Evidence and experience
What the evidence and two decades of surgical experience say about pelvic pain when sitting.
If your pelvic pain increases the longer you sit and improves the moment you stand up, that pattern is clinically meaningful. Sitting compresses the pudendal nerve between the sacrotuberous and sacrospinous ligaments, which is why nerve-related pelvic pain follows posture so closely.
Patients often adapt without realising it: driving with one hip lifted, standing through meetings, avoiding restaurants, cinemas and flights. In New York, where commuting and desk work dominate the day, this symptom quietly reshapes a whole life long before anyone names the cause.
At Pelvic Institute we map the exact positions that trigger and relieve your pain, because that map is one of the strongest indicators of pudendal nerve involvement and guides where we look during diagnostics.
Dr Bollens is a professor of urology, a proctor in pelvic surgery and a published author on pudendal neuralgia.