Pain when sitting
Worse with desk time, driving or flights, and better standing or shifting position.
Perineal pain is a symptom with more than one possible source. It is often worse sitting at a desk, driving or flying, and it eases with standing. Squats, lunges and cycling can make it flare.
The perineum sits where the pelvic floor, adductors and deep hip rotators meet. When these muscles hold tight or develop trigger points, knots of muscle that refer pain, they can send pain into the perineum. The pudendal nerve passes through this area, and it can be pressed on or become sensitive. Burning, tingling or electric pain that changes with position often points to the nerve.
For these muscles and the area around the nerve, I use dry needling, a form of acupuncture. The obturator internus and levator ani can squeeze the pudendal nerve in Alcock’s canal, a tunnel along the pelvic wall. Needling them aims to relieve that. If the pudendal nerve has become irritable on its own, I add electroacupuncture. A gentle current runs through fine needles near it to help change its signaling.
Most people have had imaging to rule out serious causes and sometimes medication for pain or inflammation. Imaging rarely shows muscle tone, trigger points or a nerve that’s sensitive to pressure. Medication can ease symptoms without changing the tightness and pressure in the pelvic floor and hip. In New York, dry needling is not something a PT or chiropractor can do. That makes it different from pelvic floor PT you may have tried.
I start by asking about sitting, including the surface, the angle and how long, plus which movements set it off and what reliably eases it. Then the exam:
I work alongside urology, gynecology, pain medicine and pelvic floor PT. Where my findings suggest a return to one of them, I’ll tell you and share the details of the exam.
Not always. The nerve can be involved, but often the pain comes from tight pelvic floor or hip muscle. Relaxing the obturator internus can ease pressure in the pudendal canal too. Gentle current near the nerve can help if it stays irritable. Most perineal pain needs a combination, since more than one source applies.
Sitting changes the angle of the pelvis and adds pressure to tissue that shares space with the pudendal nerve. If the pelvic floor or adductors are guarding, or the nerve is sensitive, long sitting can bring on pain. Nothing may show on a scan.
Internal work isn’t something I do. I treat externally, working on the pelvic floor, adductors, deep hip muscles and the nerves involved. If internal treatment would help, I’ll refer you to a pelvic floor physical therapist.
It depends on how irritable it is, how long you’ve had it and how many sources are involved. I reassess every few visits and adjust.
Often yes, with changes. I help you adjust volume, positions and loading so you can keep training without repeatedly provoking the same pain.
Seek same-day care for sudden severe pain, fever, rapid swelling or new trouble urinating. New numbness in the saddle area, progressive weakness or quickly changing neurological symptoms also need urgent evaluation.
Adults with pelvic floor, nerve and orthopedic pain, along with neurological conditions. Most of my patients come to me after other care hasn't fully settled things. If you're looking for general wellness acupuncture, I'm not the right fit.
We review your history and what you've already tried. I assess the muscles and nerves involved, and you're treated the same day.
It depends on the condition. Pelvic and orthopedic plans usually run 4 to 6 weeks. Neurological plans are usually 2 visits a week for 6 weeks or 3 a week for 4. After that, visits space out so the changes hold. These are typical timelines, not promises.
Yes. I work alongside doctors, physical therapists and specialists. If something I find needs a closer look from one of them, I'll tell you.
I'm an out-of-network provider. You pay at the time of your visit, and my office submits the claim so any reimbursement comes to you. Free benefit checks are available before your first visit through the verification form, and HSA and FSA cards work. I don't take Medicare or Medicaid, though some Medicare Advantage plans reimburse out-of-network care. Full insurance details
Yes. I treat adults, teens and children, though I don't specialize in infants or toddlers.
Yes. Book a free discovery call to ask your questions and see whether we're a good fit.
Dry needling is a form of acupuncture. Fine needles go into tight bands of muscle and trigger points to lower muscle tension and change how the area is signaling.
You may feel a brief twitch or a deep ache as the needle reaches tight muscle. It passes quickly, and any soreness afterward usually fades within a day or two.
It's generally safe with a properly trained practitioner. Needles are sterile and single-use, and I check your health history first, including blood thinners. In New York, dry needling can only be performed by licensed acupuncturists, MDs and DOs. Physical therapists and chiropractors aren't permitted to perform it.
Eat something light beforehand and wear loose clothing that lets me reach the area being treated.
Usually not. Ultrasound helps in a few specific cases, but it hasn't been shown to improve results for common trigger points. A careful hands-on exam is what guides the needle. More on ultrasound-guided dry needling
Dry needling aimed at the pelvic floor and the hip and abdominal muscles around it, for pain, tension and urinary symptoms driven by those muscles and their nerves. More on pelvic floor dry needling
Sometimes, depending on the muscles involved, and you'll be draped throughout. Treatment always follows your consent and comfort. I don't do internal exams or internal treatment.
No, though it helps if you've already seen a doctor or pelvic floor physical therapist. Bring any notes or imaging you have.
Completely. I've heard it all, and there's no judgment here, just a straightforward conversation so we can treat what's going on.
Yes, I treat adults of every gender and identity. After gender-affirming surgery involving the pelvis, bring your surgical notes and we'll decide together what fits.
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118 W. 72nd St, Rear Lobby, New York, NY 10023
Evidence-based acupuncture and dry needling on the Upper West Side. From chronic pain and headaches to pelvic floor dysfunction, Dr. Jordan Barber pairs the highest level of training with care that actually listens.
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