Chronic spermatic cord pain 7-8 mnth.

Doctor, I have had persistent left spermatic-cord/scrotal pain for around 7–8 months. The pain is mainly at the back of the testicle/above the testicle along the spermatic cord, sometimes spreading toward the groin. There is also a specific tender point where the scrotum meets the body. It is present most of the time and worsens after masturbation, prolonged sitting/travel, and sleeping on my stomach or side. Standing sometimes gives relief. I previously took Duloxetine 20 mg, Gabapentin + Methylcobalamin, and Pregabalin + Methylcobalamin for around 6 months month. They reduced the pain somewhat but did not completely resolve it. I want to know whether this is nerve-related spermatic-cord pain or another cause, and whether a diagnostic spermatic-cord/nerve block or other conservative treatment would be appropriate.