Chronic Pelvic Pain

Pelvic pain is an uncommon but significant problem in some women. Careful assessment of pelvic pain with a reasonable diagnosis and comprehensive treatment program is the first step toward relief and return to function. The physiatrist is the medical specialist best suited to incorporate the neurological and musculoskeletal systems into an effective treatment plan.

Studies Show:

  • Nearly 15% of women aged 15-50 in the U.S. suffer from chronic pelvic pain

  • 10% of all visits to gynecologists are for pelvic pain

  • About 50% of women with chronic pelvic pain feel depressed and less active.

  • Over 60% of women with chronic pelvic pain have not been provided a specific diagnosis

What you should know:

  • The pelvic floor muscles act as a muscular sling that supports the pelvic organs and openings of the vagina and sphincters and can be injured or weakened causing pain

  • Chronic pain can continue long after tissue injury has healed, and is often due to nerve and muscle problems.

  • Musculoskeletal alignment problems with the pelvic bones including the sacrum and pubic bone can cause pelvic pain

  • Gynecological conditions (endometriosis, ovarian cysts), urological conditions (urinary tract infections, interstitial cystitis) and colorectal conditions (polyps or colon cancer) should be considered as sources of pelvic pain and should be assessed as possible causes

  • Chronic constipation or diarrhea can lead to pelvic floor dysfunction and pelvic pain can become very debilitating

  • Men can suffer from chronic pelvic pain, too

What you can do:

  • A physical medicine and rehabilitation physician (physiatrist) can evaluate you for pelvic nerve problems and/or pelvic floor muscle dysfunction from injury, previous surgery, labor and delivery related conditions, and other chronic pain states

  • Treatment prescriptions may include:

    • Ice and heat
    • Physical therapy by an expert in pelvic floor therapy
    • Education to isolate, recruit and strengthen the supportive pelvic musculature with an appropriate exercise program
    • Electrical stimulation to assist with strengthening when moderate to severe weakness is present
    • Biofeedback to assist with relaxing painful, hyperactive muscles
    • Pain medications and injections to treat inflammation, muscle spasms and nerve pain

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