Pelvic Pain

Pelvic pain is located between the navel and the hips and groin. If it lasts for six months or more it is called chronic pelvic pain. It is often difficult to determine the source of the pain. Pelvic pain can be caused by problems related to:

  • Female reproductive organs
  • Intestines
  • Nerves
  • Bladder
  • Prostate

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Chronic pelvic pain can be caused by a wide variety of conditions.

  • Gynecological conditions
    • Endometriosis
    • Pelvic inflammatory disease
    • Fibroids
    • Pain when ovulating
    • Menstrual pain
    • Adenomyosis
    • Cysts
    • Pelvic congestion syndrome
  • Psychological conditions, such as depression, or a history of physical or sexual abuse
  • Neuromuscular conditions
    • Pudendal neuralgia
    • Muscle pain
    • Nerve pain
    • Lower back pain
    • Joint and bone pain
    • Muscle strain

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Having one of the conditions listed above increases your chance of having chronic pelvic pain. Other factors may include:

  • Miscarriage
  • Cesarean section
  • Alcohol or drug abuse
  • Heavy menstrual flow

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Symptoms may include:

  • Constant pain or dull ache in pelvic area
  • Burning, shooting pain
  • Rectal urgency
  • Pain that comes and goes
  • Pain that ranges from mild to severe
  • Pain with certain activities
  • Pain with prolonged sitting

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You will be asked about symptoms and medical history. A physical exam will be done. You may be asked to keep a pain journal to help the doctor diagnose the pain. You will be asked to write down when the pain occurs, how it feels, and how long it lasts. Bodily fluids may be tested. This can be done with:

  • Blood and urine tests
  • Cultures and swabs
  • Tests for sexually transmitted diseases (STDs)

Bodily structures may need to be viewed. This can be done with:

  • Laparoscopy
  • Cystoscopy
  • Sigmoidoscopy
  • Intravenous pyelography
  • X-rays
  • MRI scan
  • CT scan

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The source of pelvic pain can be from many different causes.  Depending on the findings of the physician and results of the physical therapy evaluation, your therapist can design a program that helps restore strength, range of motion, muscle control and awareness.  These interventions along with other modalities, like biofeedback and manual therapy, will help reduce pain and restore function.

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Preventing chronic pelvic pain depends on the condition causing it. Some causes are not preventable. STDs cause many conditions that result in chronic pelvic pain. Use latex condoms every time you have sexual intercourse, and minimize the number of sex partners you have.

This content was created using EBSCO’s Health Library

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RESOURCES:
  • The American Congress of Obstetricians and Gynecologists

http://www.acog.org

  • The International Pelvic Pain Society

http://www.pelvicpain.org

CANADIAN RESOURCES:
  • Health Canada

http://www.hc-sc.gc.ca

  • The Society of Obstetricians and Gynaecologists of Canada

http://www.sogc.org

REFERENCES:
  • Chronic pelvic pain. American Academy of Family Physicians Family Doctor website. Available at:  http://familydoctor.org/familydoctor/en/diseases-conditions/chronic-pelvic-pain.html Updated April 2014. Accessed June 18, 2014.
  • Chronic pelvic pain. The American Congress of Obstetricians and Gynecologists website. Available at:  http://www.acog.org/~/media/For%20Patients/faq099.pdf?dmc=1&ts=20130611T1540053024 Published August 2011. Accessed June 18, 2014.
  • Chronic pelvic pain. EBSCO DynaMed website. Available at:  http://www.ebscohost.com/dynamed Updated April 23, 2014. Accessed June 18, 2014.
  • Chronic pelvic pain. The International Pelvic Pain Society website. Available at:  http://www.pelvicpain.org/docs/patients/Patient-Education-Brochure.aspx Accessed June 18, 2014.
  • Levy BS. The complex nature of chronic pelvic pain. J Fam Pract. 2007 Mar;56(3 Suppl Diagnosis):S16-17.
  • Reiter RC. Evidence-based management of chronic pelvic pain. Clin Obstet Gynecol. 1998;41(2):422-435.

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A Look at Treatment

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