To pick up on what Mr. Spellwin suggested and before you go chopping things off, you have to find out first what is causing the pain.
If your foreskin is tight, a condition called Phimosis, then you can stretch it over time so that it can be fully retracted without any discomfort. You can also have a urologist make a small slit in the end, much like peeling a banana (best way I could describe it, lol, sorry). The steroid cream mentioned is called Betamethasone 0.05% but is also listed under different names. Again, you would have to speak with a urologist about that.
If the pain is the result of the frenulum, the small piece of skin under the glans (head) of your penis and attaching to the shaft, then you can have a frenuloplasty to correct the tightness.
If all else fails, then you can opt for a circumcision. But I wouldn't use 'hygiene' as a condition for circumcision especially since you have gone 21 years without it.
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KP -- Fitness Basics