About Pelvic Pain
The pain from inflamed affected pelvic organs can cause radiation of symptoms and pain to an area distant from the actual pathology.
This is called referred pain as opposed to radicular pain which is caused by the irritation of a large spinal nerve.
Pelvic pain may be acute or chronic.
The pain is usually described as aching and vaguely localized.
The pain is usually worsened depending on the pathology, with walking, urinating, lying down, coughing, bowel movements, menstruation, and sexual activity.
The pain may arise from any of the pelvic organs or surrounding musculature. Common causes of chronic pelvic pain include hernias, urinary bladder infections, endometriosis or tumors, ovarian, uterine pathology, malignancies, and infections.
Diagnoses involve a thorough history and physical as well as proper imaging including CAT scans, x-rays, MRI, and bloodwork in certain cases. Endoscopy, cystoscopy, and PET scans may be useful.
Coordination with the patient’s general practitioner, urologist, gynecologist or oncologist assists in proper diagnosis.
Treatment options include analgesics for temporary pain relief, low-dose antidepressants which are helpful in both sleep and chronic pain, as well as opioid use for worsening chronic pain. Behavioral therapy can be used with success as well as acupuncture.
Physical therapy includes home exercises to help strengthen and improve the core, and pelvic floor muscles.
Diagnostic / Therapeutic spinal injections (sympathetic blocks) with or without supplemental steroids may also be effective and augment the effects of oral medication and physical therapy.
If these fail one can be evaluated for their candidacy for surgery. Spinal cord stimulators have also been used successfully in certain conditions.