Hello @thejimhale and welcome to Mayo Clinic Connect. While you have more trigger points than relief options, it is good to see you found walking to be somewhat of a relief option while you explore seeing a specialist.

I have actually moved your post into an existing discussion going on in the community on the topic of pudendal nerve entrapment because I believe you will be able to more quickly hear from other members already there. You can find the discussion here for reference: https://connect.mayoclinic.org/discussion/pudendal-nerve-entrapmentneuropathydamage/

That said, I'd like to bring in members such as @pwgrimes @clashganny @olivedog @user_ch98d0b5c and @grabofsky who have all been recent contributors to this discussion. They come at this from diverse perspectives and may be able to share their experiences with you.

I wonder if you've considered seeking care at Mayo Clinic in Florida as a potential option?

You may want to go to a colorectal doctor. They specialize in the rectum and anal area. Gastroenterologist do not. I have had 5 colonoscopies in the last 10 years. They saw nothing. I finally was tested for Celiac, an autoimmune disease of the intestine that is genetic. Having to go Gluten Free has been hard. Food was a big part of my traveling and cooking. But the painful problem I have now is in the anal sphincter muscles. I may have an anal fissure. Standing or walking is bad as well as sitting. It is 24 hours now. I am waiting for the colorectal Dr. To call me. Before I had the Celiac diagnosis they all said I had IBS or pelvic floor dysfunction. None thought of Celiac. It has not been researched a lot and most dr. Do not even know of it. They did think it was a peudendal nerve problem and I had dozens of nerve blocks. The problem is it is very hard to access it because it is at the bottom of the spine and is almost hidden. My town of Redding does not have a doctor who knows Celiac for 100 miles. I am not sure your symptoms are in the over 200 listed. Check Mayo Clinic on the internet. I had a PN test and it just about killed me. It was definitely painful, so it could have been inflamed. Look under colorectal doctors to see their specialty’s . I also have many other genetic problems. I have used 5% lidocaine, but think it is burning now. Good luck. The doctors don’t want to treat people with difficult problems. That is why a clinic like the Mayo Clinic is good. We only have one in the west, Phoenix. There are several in the east. The university of Chicago and Cleveland Clinic have team treatments.

I had 2 MRNs at Stanford. While they confirmed damage to the nerve they were not able to pinpoint the location so not that useful.