Most likely will have to travel far to find facility to treat pudendal area.
Autoimmune diseases, Chronic pain, Neurology (brain and nervous system), Other
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Peripheral nerve surgeons (dellon institute) can be helpful when other doctor's fail. They actually work with "all" peripheral nerves. However, the surgery for pudendal problems is difficult, so most pelvic surgeons don't ever learn it.
Muscles/ligaments can entrap nerve so going up to spinal level seems like more of a pain mgt solution and not really treating the likely source of the problem which is in your butt. The surgery is difficult and very few surgeons want to do it. Germany seems to have best pelvic center to treat these problems. France also has doctor who is really good. If you search PubMed for pudendal neuralgia, you may find more treatments.
Sun, Feb 9 6:51am · Undiagnosed Autoimmune with back pain, spasms, and stiffness in Autoimmune Diseases
I would investigate POTS, Postural Orthostatic Tachycardia Syndrome. Usually, this causes a multitude of symptoms but is not known by most medical providers. It is disorder that causes problems with blood flow and tachycardia. If you feel lightheaded and have unrefreshing sleep after waking in the morning and it gradually improves throughout day, that is typically an indicator. The longer you stay in bed, the worse it would get. If these symptoms don't sound like a match, I would look at other central and peripheral nervous system problems.
You need to see Peripheral Nerve Specialist from Dellon Institute. Your symptoms suggest multiple nerve entrapments which is usually the cause of chronic pain ultimately leading to changes in muscle tone and many other problems that result down the line. They are expensive, but you will have much more insight into your problems. Pain management generally is not in the business of diagnosing peripheral nerve problems. They will drug you and send you to psychiatrist/psychologist which will help, but again is limited.
Sun, Feb 9 6:33am · Any experience with DRG stimulator for pudendal neuralgia? in Chronic Pain
The Dellon Institute has surgery for pudendal neuralgia but they don't really have any good way to diagnose. I suppose if you already have diagnosis, that would help. Germany has an institute to deal with pelvic problems under Dr. Posson, but it is Germany so may be difficult to try them. Pain management doesn't always treat this, but some pm docs will do injection and maybe RFA. RFA can cause nerve damage so it is not always best step according to peripheral nerve specialists that do the surgical release. However, surgery has a lot of risks unless surgeon has done a lot of these releases. I don't believe pelvic floor therapy makes much difference, but that is another safer option. Using special cushions with the center line where perineum sits cut out of foam is helpful and cheapest treatment.
Sun, Feb 9 6:24am · Chronic abdominal pain after cystectomy and or inguinal hernia repair in Chronic Pain
Most likely genitofemoral nerve is entrapped in mesh. Would get ultrasound of inguinal hernia mesh area to see if nerve is "enlarged". A good hernia surgeon can take out the mesh and try again without doing any damage. Now, if you had laparoscopic mesh placement then many will not do it as that would be more technically challenging.