pudendal nerve entrapment

[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