Pelvic Nerve Condition
Genitofemoral Neuralgia
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
There is burning in your groin that spreads into the scrotum or labia and down the front of your upper thigh. Walking, standing and hip extension make it worse. Sometimes the testicle pulls up for no reason. The genitofemoral nerve runs on top of the psoas muscle deep in the abdomen, and when it is irritated, this is the pattern it produces.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Genitofemoral Neuralgia
The genitofemoral nerve begins in the upper lumbar spine and runs down the front of the psoas muscle deep inside the abdomen. It splits into two branches. The genital branch passes through the inguinal canal to supply the scrotum or labia and controls the cremaster muscle, which lifts the testicle. The femoral branch supplies skin on the upper front of the thigh.
Genitofemoral neuralgia is irritation of this nerve. It is associated with hernia repair, appendectomy, C-section and other abdominal or pelvic surgery, but it can also come from tension in the psoas muscle, which the nerve lies on. Athletes, runners and people who sit for long periods with tight hip flexors can be affected.
Your physician should rule out hernia, spine and testicular or gynecologic causes. Dr. Gordon focuses on the psoas, abdominal wall and pelvic muscles along the nerve's path and on calming the irritated nerve.
Genitofemoral Neuralgia at a Glance
Also called
Genitofemoral nerve entrapment, genitofemoral nerve pain
Where it is felt
Groin, scrotum or labia, upper front thigh
Common triggers
Hernia repair, abdominal or pelvic surgery, psoas tension, running, prolonged sitting
Distinctive signs
Burning with walking and hip extension, sometimes testicular retraction
Main drivers
Psoas tension, abdominal wall scar tissue, pelvic floor guarding, nerve sensitization
The Gap in Care
What Tests Check, and What They Can Miss
Groin pain workups usually check for hernia and joint or testicular problems. Dr. Gordon assesses the psoas and the nerve lying on it.
What routine testing is looking for
- Hernia
- Hip joint problems
- Testicular or gynecologic disease
- Spine problems on MRI
What often keeps symptoms going
- Tension in the psoas, where the nerve runs
- Abdominal wall scar tissue
- Pelvic floor and cremaster guarding
- Hip flexor tightness from sitting or running
- A sensitized nerve after surgery
These are found by tracing the nerve from the psoas to the groin.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Burning groin pain
A burning or electric sensation in the groin crease.
Scrotal or labial pain
Pain, burning or sensitivity in the scrotum or labia.
Upper front thigh pain
Burning or numbness on the upper front of the thigh.
Worse with walking or hip extension
Pain increases with walking, standing or stretching the hip.
Testicular retraction
The testicle pulling up involuntarily, from cremaster muscle activity.
Pain with sitting and sex
Discomfort with long sitting or during intercourse.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Psoas tension
The nerve lies on the psoas. When the psoas is tight or in spasm, it irritates the nerve.
Abdominal wall scar tissue
Surgical scars can tether the genital branch near the inguinal canal.
Pelvic floor and cremaster guarding
Groin pain causes protective tightening that adds to genital symptoms.
Nerve sensitization
An irritated nerve becomes reactive to movement, pressure and touch.
Your First Visit
How Dr. Gordon Evaluates Genitofemoral Neuralgia
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your surgical history, imaging, urology or gynecology findings and prior treatments.
Psoas and abdominal wall assessment
Careful assessment of the psoas, abdominal wall and surgical scars along the nerve's path.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Hip and movement testing
Dr. Gordon tests hip extension, walking and sitting positions that change your pain.
Plan and coordination
A clear plan, plus communication with your physician or pelvic floor PT when that helps your care.
When to see a physician first
- Fever with groin swelling or redness
- A painful bulge in the groin that does not go back in
- Sudden, severe pelvic or abdominal pain
- Rapidly worsening leg weakness
- Visible blood in the urine or stool
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for genitofemoral neuralgia, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment releases the psoas, abdominal wall, hip flexor and pelvic floor muscles along the genitofemoral nerve's path. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along the lumbar and groin nerve pathways to calm burning and sensitivity.
See servicesBetween visits
Movement Plan & Team Coordination
Guidance on sitting, hip flexor load and training, coordinated with your physician.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Visits 4 to 8
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Of all the doctors I have met with Doctor G.has been the most kind, caring, empathetic and patient. I feel like most doctors don't listen but Dr. G took the time to make sure I was heard."
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Genitofemoral Neuralgia Questions
Answers About Genitofemoral Neuralgia
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
Both cause groin pain, but the genitofemoral nerve also supplies the upper front thigh and controls the cremaster muscle. The exam helps tell them apart.
The nerve runs directly on the psoas muscle, so tension there can irritate it.
Yes, when done by a trained provider with detailed anatomical knowledge. Dr. Gordon adjusts technique to your comfort.
Yes. Psoas tension from running, sitting or training can irritate the nerve.
Most people need eight to twelve sessions with reassessment.
No. Treatment focuses on the abdomen, hips and pelvic floor along the nerve's path.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For genitofemoral neuralgia, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the deep pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped. Needles are placed through the skin only, and nothing is ever inserted into the vagina or rectum. You can pause or stop at any time.
Yes. Genitofemoral neuralgia can affect people of every gender, and Dr. Gordon treats adults of all genders and identities.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a physician for your pelvic symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Genitofemoral Neuralgia
Book a full evaluation with Dr. Gordon and find out whether the genitofemoral nerve is behind your pain.
Early morning, evening and weekend appointments available. Free on-site parking.
Symptoms
Common Symptoms of Genitofemoral Neuralgia
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