They thought my perianal pain was nerve pain at first too but a CT scan with oral and IV contrast showed I actually had a small anal fistula (or leakage) that was causing it. Pain meds also slowed my bowels down and made me strain more when going to the bathroom actually making my perianal pain worse. I've found that ibuprofen every so often really helps and my surgeon said it's ok once in a while but not routinely Bc it can cause pouchitis.