Hi there, I think i have a slightly different question and am having difficulty finding answers on the internet. I found out about my pilonidal sinus through investigating causes for ongoing issues having sex. (painful sex/vaginismus/pelvic floor muscle dysfunction - muscle over tightness) - the general consensus (after many doctors/physios and investigations) is that my outer muscles especially my "bum" muscles are overly tight all the time. Part of treating this was to investigate two small sinus holes one above the sacrum and one under the cleft. and low and behold i have a pilonidal sinus shown on MRI with chronic infection and cocygeal ligament inflammation. NOW - my question is --> i dont REALLY have ANY normal pilonidal sinus symptoms. Over ther last year ive had maybe two episodes where the areas around the hole in the cleft was a little red and maybe weeping, and slightly itchy or chafed, but since i changed to using a non-soap cleanser those problems have completely resolved. Also, i have always (for at least 5-8 years) complained of a sensation of tightness/inability to relax my bum/cocyx area. i do get muscle pain in the surrounding area and i even get sciatica like pain. My GP's theory is that due to the inflammation in the area from my chronic infection - my muscles are "holding on" and irritated causing this pain and most likely contributing to my sexual pain. So i want to know if this sounds plausible......or at least if a connection between these problems sounds plausible...and also if there is any evidence out there linking these two conditions. If not evidence, then maybe someone who has similar problems??? Im seeing a surgeon soon to discuss treatment options and i suppose im concerned to operate if my symptoms all under the "conservative treatment" category, however if surgery to fix this problem will help my "other issues" than it seems worthwhile. what do you think??