I'm new to this group but not pudendal neuralgia. Pain started in 2009. Was told after an xray it was pseudo gout in my proximal hamstring and was untreatable short of major surgery involving cutting the tendon, scraping the ischial tuberosity and reconnecting the hamstring tendon. Needless to say I didn't go that route. In 2015 they suggested PRP with needling of the tendon. All this did was agitate the situation. In 2017 they suggested TENEX which provided some relief but told me there was an issue with the adductor tendon and they couldn't do TENEX on the adductor tendon. In 2020 a new procedure called Tenjet was proposed and done on both the hamstring and adductor tendons. When that didn't help another ortho suggested trying shockwave therapy. That DEFINITELY was not helpful. In between I've had pelvic floor physical therapy, regular physical therapy, lumbar ablations, right SI ablation, and numerous diagnostic nerve injections. I don't know when this was actually finally diagnosed as pudendal neuralgia, maybe 2016. In 2021 they tacked on chronic pain, myofascial pain, sacroiliitis and recently fibromyalgia. They now are proposing ketamine infusions and if that doesn't help, spinal cord stimulation. There are many options to try. Be persistent and don't give up nor accept no for an answer.