Welcome @robert88, It must be just awful trying to deal with the pudendal neuralgia pain for such a long time with no relief. Hopefully other members with experience can share what helped them. While we wait for others to respond, you might want to read through the following discussion on Myofascial Release Therapy that mentions it can help pudendal neuralgia.

-- Myofascial Release Therapy (MFR) for treating compression and pain:
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Have you heard of MFR or tried other massage therapies to see if they might help relieve the pain some?

I had this monster for 14 years and sat on a donut. The only thing that finally worked was anti-seizure medicine, Topamax. Took it for an unrelated issue and in 2 weeks my pudendal nerve was better.
Mikayla

I am in Canada as well. I have lichen sclerosis which has caused nerve damage to the vulva for years, before I was diagnosed. Consequently my life was not great. I did have a couple of minor surgeries to release adhesions. Finally I was referred to Dr. Melanie Pratt. At the time she was head of dermatology at the Ottawa Civic Hospital. She correctly diagnosed my condition. Now I use Clobetasol ointment and take amitriptyline and Lyrica and my life is back on track, the nerve pain only rarely flares a bit. But all in all other problems, such as chronic tinnitus are worse by far. I hope this helps you somewhat. Good luck finding a solution.