I'm 43M, 5’10, and weigh 165lbs. I'm a non-smoker on Wellbutrin. For over a year, I’ve been dealing with erratic pain mostly in my genitals, but sometimes in other places around my groin. It appears in several ways. The main one is a stinging, electric-like pain usually in the bottom of my scrotum or sometimes a less painful pinching or prickling sensation. I also sometimes feel a surging or bulging sensation in the inguinal region of my groin. These sensations are over quickly, but can be very painful and disruptive to my day. They seem to intensify with the amount of physical activity I do.
I say it’s been a year, but I’ve had the pains infrequently, 1 to 2 times a month, for many years. They only became a bigger problem after I strained a muscle while running in March 2025. That led to me not being able to sit for a month, going to a urologist, and two months of physical therapy with a pelvic floor specialist. My PT found a stinger in the perineum area that he massaged and helped alleviate the severity of my pain. I was eventually able to sit again, but the electric stabbing sensations never went away and now happen multiple times a day.
I don’t think it has much to do with the running injury, aside from maybe being a catalyst for the more frequent pain, since the initial sensations predate the injury. I’ve seen my family doctor and an orthopedic specialist. They ordered an MRI and a CT scan. The orthopedic didn’t see anything, but the physician said they thought I had a fractured sacrum, lower back arthritis, and a bulging spinal disc between L3 and L4. The ortho eventually agreed. He advised avoiding strenuous physical activity/exercise to heal. I followed his guidance, but nothing changed after 3 months.
I’m now doubtful of their diagnosis. I work from home, so I sit a lot, but I don’t have back pain. I’ve examined my scrotum and didn’t find any irregularities. I’ve had no dip in sexual function or pain peeing. I’ve done stretching and other PT activities with no improvement. The internet has pointed me toward pudendal neuralgia. At some points, the pain also manifested as numbness in my knees and butt (a symptom), although not lately. Maybe I need pudendal nerve decompression? Any insights or doctor recs near Chicago are appreciated