I saw dermatology and they found nothing. I had physiotherapy; MRI showed sacral edema. Steroid nerve blocks and multiple medications/injections were tried without benefit.
The interventions you described (normal dermatology, sacral edema on MRI, steroid nerve blocks, multiple medication trials and injections) not producing lasting benefit suggests that neuropathic pain (for example pudendal or sacral nerve origin), pelvic floor muscle dysfunction, or a combination of mechanisms including central sensitization may be present. Recommended steps include renewed pelvic floor physio assessment (including internal evaluation, biofeedback and desensitization), neurological assessment with EMG/nerve conduction studies, review of MRI with the treating specialists, and discussion at a pain clinic about image-guided diagnostic blocks. Lifestyle measures (weight management, avoiding irritants, warm sitz baths) may help symptom control. Medication or interventional options should be decided with specialists.
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