Sacrum Injury: Symptoms, Recovery & When to See a Doctor

Question
QUESTION: Hi Doctor,
Thanks for taking time reading my question. I hope you can help me and appreciate your time and trouble. About 25 years ago I fell off a six foot latter onto a piece of concrete drain .A long piece of concrete about thee inches wide and six inches high .I hit my tailbone or sacrum. It caused me extreme pain for about a month especially on touch. I am 56 years old 6 ft 180 pounds and in fairly good shape. I didn't go and get it checked out and over a month or so the pain faded. In recent years when sitting on a flat surface my back will ache for a minute or two but I really haven't thought much about it. Recently I bought a bike and have been riding it for about a month.. Starting several miles a day and then now about 10 miles. One evening when I came in from riding I was urinating and I had a sharp pain inside my penis. I also started hurting behind the testicles somewhat. That day it hurt and the next day but yesterday It didn't hurt.Im curious if that maybe something is wrong in the sacrum where I fell 25 years ago because the bike seat puts pressure on that area and also wondered if maybe its putting pressure on the pudendal nerve there between the testicles and the anus? Do you think I did permanent damage 25 years ago and its just now showing up ? Or is the bike seat causing pain due to pressure on the pudendal nerve.Its weird because I see articles on like saying that you can get cyclist syndrome and cause some major problems in that area with being on a bike seat for a long time. I road a bike for years growing up and have never heard of that. Im really concerned .One thing is im worried that I might have had damage there when I fell years ago and now I caused more damage in that area by riding. I hope not because I really like to ride bikes and its good for you and gets you out in the fresh air. Please let me know what you think about the old injury in the sacrum and if that had any affect on it. I have had a urinary tract infection before and know what that is like and im pretty sure this isn't it and also my wife and I have been married for over 20 years and we haven't had sex with others so no std's..Other than that the old injury is about all I can think of that maybe the culprit.Thanks in advance for your thoughts. Michael

ANSWER: It is unlikely that you damaged something 25 years ago and now it is just showing up.  Even given that you are doing a new exercise.

You are right though, it is likely you are getting some pudendal neuritis.... but it is probably just because you are 56 years old and starting a new exercise.  

I hope this helps.

---------- FOLLOW-UP ----------

QUESTION: Dear Doctor,

Sorry to be a bother again but I have been thinking about your reply.I was curious about the pudendal neuritis.Can this last sometime? say over a month? At the moment it kind of comes and goes. There is something like a muscle spasm just in the lower part of my back that feels like its jumping around. Its place is right over my buttocks crack.
It seems to bother me after walking and moving around.I will sit down and it will start to spasm and then I can feel weird pain through my penis and scrotum and rectum.Its not terribly painful but rather annoying.My urine flow isn't what it used to be and I don't urinate anymore than I have before.I don't have any pain on urination or blood in my urine or fever or chills and all the things that goes with prostate.I really had no change other than a slower flow of urine than I did a year ago. I have done alot of research over the time since your answer and it seems that it is probable that I do have something to do with that pudendal thing.I have read accounts of people giving descriptions of what I have almost to a tee under the heading pudendal problems..But then again if I read under prostate problems its kind of there. I have found that many doctors can't really specify if what is occurring with me is prostate problem and people all over the internet say they have been treated for prostate trouble and found that wasn't the issue. My wife said that she experienced some type of pain of this sort when she had children after giving birth.She describes it exactly. Then I have also read that many people that injured themselves the way i did many years ago still has constant problems with that area,even after 30 years. I was just curious bottom line..Could this just be something that is bothering me and it takes longer to heal since im 56 than it would if I was younger?We live in a very rural area and its a major thing to go to the doctor. I really kind of wanted to put my mind at rest if you think its just something temporary and will eventually go away. The symptoms seem to come from that spasm feeling in my back.. When that isn't going on then I am symptom free but when it starts I get those annoying things I told you about with the slight pain in the penis and anus and scrotum. Like I said the pain is more annoying than anything but hopefully it will go away.Any encouragement you can give me will help alot.I thank you in advance and greatly appreciate it. Michael  

Answer
certainly at this age, your prostate is enlarged.... and that is probably some of the decreased urination symptoms.  I would consider treating that with one of the alpha blockers and see if that has effect not only on the prostate but the whole area as well.