The theory is that if the problem is from hypertension of the pelvic floor muscles then yes to your last sentence
except the never sitting again.
The best way forward for you is physiotherapy with someone who is PN aware (so you can tick that box)
Medication. . . I would also try combining the gabapentin with an anti depressant like cymbalta. This only needs to be taken at a low dose although you can always titrate up and see if there is any benefit, however it is usually thought that more anti depressant doesn't always mean more pain relief and the lower dose is as effective as as higher one with neuro pain. The gabapentin dose can be increased to good effect, but that should be discussed with your doctor of course. The combination of the anti seizure and anti depressant can be effective although it is often a bit of trial and error to see what works individually. You already know how you are with the gabapentin, so introducing another drug separately will be easier evaluating any benefits.
You have already found relief from the clitoral pain, which would be the dorsal pudendal nerve branch, with conservative therapies so there is no reason why conservative treatments shouldn't work this time. I know it is probably the hardest thing to do but try not to worry as this will only exacerbate the problem. . . . . .then you worry about how to stop worrying
Having mindfulness training is also a great idea, as it can help enormously, any cognitive therapies can be extremely therapeutic and help with coping strategies and hopefully lessen the worry factor.
I did see a comment by David Butler (Co-Author of explain pain
http://www.bodyinmind.org/resources/books/) that you can stand on a nerve and it will survive. Sorry I can't find the reference now.
It probably says something similar in his book (above) but it is expensive and I haven't read it (yet).
Much of the pain management treatment available now is based on this 'pain in the brain' concept. A synopsis of the book is detailed below.
EXPLAIN PAIN.
A ground-breaking concept in its content and presentation, Explain Pain demystifies the process of understanding and managing pain. It brings the body to life in a way that makes an interesting read for therapists and pain sufferers alike. All pain is real, and for many people it is a debilitating part of everyday life. It is now known that understanding more about why things hurt can actually help people to understand their pain. Recent advances in fields such as neurophysiology, brain imaging, immunology, psychology and cellular biology have provided an explanatory platform from which to explore pain. In everyday language accompanied by quirky illustrations, Explain Pain discusses how pain responses are produced by the brain: how responses to injury from the autonomic motor and immune systems in your body contribute to pain, and why pain can persist after tissues have had plenty of time to heal. Explain Pain aims to give clinicians and people in pain the power to challenge pain and to consider new models for viewing what happens during pain. Once they have learnt about the processes involved they can follow a scientific route to recovery..
Take care,
Helen
I fear I have PN. It started with UTI and moved on to vulvar pain. That gradually subsided after 2 months. Unfortunately I then sat on my cushion but in pain for 2 hours and now have constant pain in anus 24/7. Have I permanently damaged nerve or is there hope it will heal in time?