pudendal nerve entrapment

[cmermier]

I have been recently diagnosed with pudendal nerve entrapment. It is very painful and the only solutions I have been given by doctors is to stop cycling altogether for some unknown amount of time, and to take neurontin (an anti-seizure druf that helps with nerve pain). I have not ridden for 3 weeks, and the pain remains. Upon researching this condition, it seems somewhat common in long distance cyclists, and 2/3rds of cases are women, according to one source.

Anyone ever dealt with this issue,and/or have any suggestions to help me get back on the bike? Thanks

[mimitabby]

sounds like a fancy name for bad saddle fit syndrome.

Have you tried different saddles ? have you been professionally fit to your bike?

I'm sorry to hear this.

[cmermier]

Thanks for the reply. I've had 2 professional fits, tried many saddles, ride with 2 pair of bike shorts, have 2 different bikes with different saddales and have have deep bruises on my ischial bones anyway- this is different though - it's an intense burning pain in the groin area that is constant....

[makbike]

Have you considered a recumbent?

[cmermier]

I am very resistant to a recumbent. I just want to ride my regular bikes. I feel like it is already dangerous enough riding a little higher up here in a big city, but down low seems suicidal (sorry to those who ride recumbants). Also, when I have ridden a recumbant stationary bike, I have been very uncomfortable- it seems to cause me low back pain....

[KnottedYet]

Can you get to a Pelvic Floor physical therapist? There are treatments for pudendal nerve entrapment, and they don't require you to quit cycling.

Google Pelvic Floor Therapist, Pelvic Pain Therapist, and Incontinence Therapist in your area. Not that this causes incontinece, but most PTs who have advanced training in incontinence will also know how to treat pudendal nerve problems.

If that doesn't prove fruitful, try contacting the folks at this website and ask for a list of their trainees: www.pelvicrehab.com

It would certainly help if the pelvic floor therapist you find is also a cyclist! (we are out there, just gotta find us!)

[cmermier]

Hello all- An update on this condition...someone replied that it sounded like a fancy name for a bad bike fit. It is the end of Jan., 2008. I have not ridden my bike since mid-September and am still in excruciating pain. I am taking several medications for nerve pain and have had one steroid injection with no relief. There are several Pelvic Pain centers throughout the country that help women (and some men) with this condition. It is real and not a fancy name for anything.

If you have chronic pain in the perenial area, don't write it off as just saddle sores as I did. I hope that someday I can ride again, but right now just sitting is painful. As background, I increased my mileage from 125-150 miles/week to close to 200 miles/week. I also lost weight during this time. These things may have been the staw that broke the camels back (so to speak) that made this nerve become inflamed. Be careful out there and have fun.

[mimitabby]

I read my own sarcastic comment above and I have to apologize. Sometimes on line, it's easy to just say something like that in the hopes that there's an easy solution.

I hope that you can look into what KnottedYet suggested and i also hope that
you recover... SOON!

[AnnR]

Currently dealing with this issue and found this forum. Have first gone to a chiropractor which was a first as I am in the women's health care field myself, but did not get any help with the tailbone pain. Primary doctor had me get a regular lower back x-ray which just showed a minor displacement that she said was no worry.
With some help from my coworkers, I got directed to the departments pelvic floor physical therapist. Also have been told to get a new bike seat. Last year I had a proper bike fit. Last year got a new saddle which took care of the labial lesions the old one caused. Non riders don't understand that it is very difficult to just buy more and more saddles to try out without guidance as to what might work.

PT and I are thinking of an injection nest as the therapy doesn't seem to helping yet. Funny, it doesn't hurt while on the bike, well the lower back does but not the tailbone itself.

I'll keep searching as I don't intend on not riding.

[KnottedYet]

Funny, it doesn't hurt while on the bike, well the lower back does but not the tailbone itself.


Doesn't hurt while you're on the bike.
Pelvic floor therapy isn't helping.
Does it hurt when you lift OFF of the saddle?
Is it more tailbone pain, rather than pudendal distribution pain?

It doesn't sound like pudendal nerve entrapment. It sounds like a saddle that is forcing you to weightbear on the floor and causing tensile stress to the tendons and ligaments that insert on the coccyx. (in turn deranging the sacrococcygeal joint) The tensile problem is one of those odd things that doesn't hurt under pressure, but hurts more when the pressure is relieved. Which is, of course, the exact opposite of the symptom pattern of a neural compression problem.

Ask the pelvic floor PT to measure you for saddle fit. Check to be sure that your saddle top isn't too domed or too padded.

I'd be looking for mechanical causes before injecting the nerve. Especially when your concordant sign is low back pain!

(if your PT doesn't know how to measure for saddle fit, there are several threads here that describe how and that also explain how the saddle measurements need to correlate to your lateral-to-lateral ischial tuberosity span and your point-of-contact-to-point-of-contact span. Note, this is NOT pelvic outlet span!)

[KRISG]

This is indeed something very painfull . I suffer from it 6 years now .
The only thing I can ride on is a recumbent bike .
All info about it here http://www.pudendalhope.org

Kind regards