Possible S3 nerve damage

Have you gotten relief for your sitting pain? I think I may have PFCN issues.

Hi @cake, while you wait to get a response to your question from @lowth21, I wanted to welcome you to Mayo Clinic Connect. Can you share a bit more about the pain you experience with sitting? Have you been diagnosed with a specific issue with the posterior femoral cutaneous nerve?

Hi GRAVEY, from Georgia in Australia Yes, I have a S 1 to 4 called a Sacroiliac Joint degeneration. It was diagnosed by all the same things you had. MRI, CT and various exploratory procedures (needles in the lower back) I stayed on high dose of pain meds while "they poked around". Pain was in the lower buttock and down the hamstrings --it got to about 10/10 "excruciating" at times but the meds stopped the pain.
Three choices to stop it : PRP, RFA or FUSION of the 4 nerves of that "S joint" will stop the nerves from sending pain messages. I selected Radio Frequency Ablation. (sort of burning of the nerve !!" because it was least invasive. Fusion for someone my age is not preferred. The other PRP I could not have because I have a very high platelet production. (technical- they put in your own platelets and try to regrow the damaged cartilage in that area. ) .!!
I am having this done next month.

Hi gravey. from Georgia in Australia . Yes I have at present an S 1 to 4 Sacroiliac joint degeneration. Wow pain is 10/10 at times. Had all the scans you named, also. But the "blocking injections" to the S1, 2,3,4 nerves told then where it was exactly. These are rather mild injections done in outpatient surgery in your lower back under mild anesthetic. Then you go home and they ask you to keep a diary. How did it feel after one hour, two hours etc. If they blocked the "hurting nerve" they can tell from this.
So I was offered three solutions.
So I was offered PRP, RFA or FUSION. PRP (50% chance of success, newish treatment ) is an injection of platelets to see if it will heal the damaged cartilage etc. RFA is Radio frequency Ablation where they kill the affected nerve with heat. And FUSION is where they fuse the joint so it will not move and cause pain.
I selected RFA which I will have shortly. As soon as C-virus is lifted.

Hi @australia. I know what you mean. I have degeneration that has caused a scoliosis and my T-4,5 and S1 has stenosis. I did have the Ablation, but it only helped for about a week or 2. I am now going to have a fusion from T-10 to my pelvis. It's a big surgery, but I am so ready and looking forward to it. Seems funny to look forward to a surgery like the one I'm having, but I'm hurting too much. I hope Your RFA works for you. It's a good choice. I'm still waiting for Mayo Clinic to do elective surgeries. The stupid Covid-19 really messed things up. I live in Iowa and Mayo is in Rochester, Minnesota, so it's a 3 hr and 30 minute drive, but it's worth it. Best luck and let me know how you come out. If I don't respond you know I'm recovering from my surgery. Take care of yourself!

Hi John. Thanks for posting. Can you please supply the name and hospital of your neurosurgeon? I am in desperate need of testing to determine how to help my pain. Been through surgeries etc. But no great diagnosis so no success. Thank you!

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I have OA of spine, stenosis of partial T-spine, and lumbar spine. I had similar type pain along with my other associated pain in my legs and butt. I presume my superficial butt pain elicited from S3. I’ve done PT too and best medicine I’ve had. My butt pain did go away but I still have my chronic pain that is here to stay.

If there is no apparent answer from the MRI, etc., it seems like an enigma.
I have continuing pain in my butt (and down to my ankle), but the cause is evident from the MRI and X ray. I am considering the insertion of a rod and screws in the L 4/5. I'm told that it is a "simple operation," (I've heard that before.) 🤔
Last oct (1019) I had discectomy on the L 4/5. Unfortunately there is currently a compression on the the L 4/5 nerve; I suspect that my be your issue.
PT never helped, often causing more pain; tough to find a great PT who follow your needs rather than their procedure.
Best of luck to you and all of the rest of us.st of luck

Best of luck on your impending surgery.