I have been following this thread closely for a period of time and it feels my duty to share my story.
My pudendal nerve issues started in Nov 2023. I passed a stone of some sort (maybe kidney, most likely bladder or prostate) at 6am on a Sunday morning. 10/10 pain that I will never forget. After passing the stone, I promptly jumped on the trainer to finish my workout before the family woke up (not advised).
Following the subsequent bladder infection I was found to have prostatitis. This cleared up and symptoms went away after a week or so. I started to develop classic PN pain and did not realize what it was so I tried to ride through it for about 2 months. I also battled constipation quite badly, having a bowel movement only 1-2x weekly. Sitting, even in a previously comfortable chair, was painful so I nearly always stood at my desk while at work. Even my 15 minute drive home from work was uncomfortable. My worst stretch was driving 2.5 hours to an airport followed by a 4 hour flight to Mexico. I was backed up for 5 days.
I tried PT for 8 weeks which helped, but symptoms were still present. I paused on the bike starting in Feb 2024 while in PT. I religiously performed stretches prescribed by my PT every single day without fail for about 6 months straight. I still wasn’t on the bike but was lifting weights in a style similar to Crossfit. When doing heavy lifts that engaged my core heavily (squats, deadlift, snatch, cleans) or abdominal exercises, I had shooting pudendal nerve pain immediately post workout and dull pressure/burning for a couple days following.
I was up and down with symptoms including constipation. If I didn’t exercise, I felt pretty good. If I’d lift weights more than 2x weekly, symptoms returned. It went on like this for months.
Fast forward to Jan 2025, I saw a PN specialist. She confirmed PN being my issue and suggested focusing on relaxation and pelvic floor specific PT. I have always tensed my abdominal muscles since I was a child so I began focusing on deep diaphragmatic breathing and relaxing my core. This was the turning point and first step in winning my battle with pudendal nerve pain.
In Feb 2025 my pelvic floor PT did an internal exam and noticed a tight pelvic floor. She suggested taking Miralax daily which made a huge difference in constipation and was a second big step forward. This was followed by a reduction in PN symptoms.
The third step was activating my glutes with specific exercises, especially weighted and unweighted hip thrusts. This really loosened my core and lower back and helped me move more freely. After some progress my PT suggested starting on the trainer for 15 minutes twice weekly and adding 5 minutes per week if no symptoms.
Today I am still doing my original PT exercises daily, lifting weights 2-3x weekly, and riding 2x weekly for 30 minutes. I’m planning to resume the bike outdoors as the weather improves. I hope my story gives hope that PN pain, while terrible and seemingly hopeless in the thick of it, can be overcome.