The pain distribution is partially mediated by the ilioinguinal and {genito}femoral nerves and those should be needled as I described in the Advanced Course. Needling the paravertebrals specifically upper lumbar and I would also check the obturator nerve as it will refer to the lateral pelvic wall. The above in combination with manual therapy of the thoracolumbar junction/upper lumbar should give you a good result. but if the pain persists /unchanged I would move them on to a pelvic pain specialist as they may require additional and possibly direct care to perineal region.

Frank,
What are your thoughts on estim of T12-L2 at higher frequency for perineal pain? For more specific pudendal nerve pain, would you recommend DN with estim to the upper sacral segments? Thanks.