What is Pelvic Pain?
Pelvic pain explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors
Pelvic pain is characterized by pain that is felt specifically in the abdomen at or below the belly button, the pelvis, and the buttocks. Pelvic pain is a complex condition that may be caused by various underlying issues. The vast diversity of symptoms makes diagnosing the cause of pelvic pain quite difficult.
In addition to presenting diverse symptoms, pain within the pelvis can alternate from mild to moderate or severe. The pain may also be periodic or chronic as well as sharp or dull. This means that pelvic pain may be felt as constant, throbbing discomfort or experienced as single, brief episodes. Furthermore, pain may be localized in specific regions of the abdomen or pelvis or radiate through the lower back and thighs.
The occurrence of acute pelvic pain is quite common among the general population and the prevalence rate for women is somewhat high at 33%. In the past, the high rate of pelvic pain in women in particular caused this condition to be frequently linked to underlying gynecological issues, but this assumption often led to misdiagnoses as there are numerous factors that may lead to the development of pelvic pain. The occurrence rates of chronic pelvic pain or pain that persists for at least six months is approximately 3.8% for women. Pelvic pain is also held responsible for an estimated 40% of annual gynecological visits.
Causes of Pelvic Pain
There are numerous causes of pelvic pain and in many cases, the pain arises as the result of one or more underlying conditions. In general, pelvic pain may be linked to one of the following systems in the body:
- Digestive system: Constipation, colon cancer, Crohn’s disease, ulcerative colitis, intestinal obstruction, diverticulitis, or irritable bowel syndrome
- Reproductive system: Endometriosis, adenomyosis, ectopic pregnancy or miscarriage, dysmenorrhea (menstrual cramping), uterine fibroids, pain with ovulation, ovarian cysts, ovarian cancer, pelvic inflammatory disease, past sexual abuse, or vulvodynia
- Urinary: Prostatitis, urinary tract infection, kidney stones, or interstitial cystitis
Conditions such as fibromyalgia, inguinal hernia, and appendicitis have been linked to pelvic pain as well. Chronic pelvic pain may also be an indication of dysfunctional muscles ligaments in the pelvic region. Furthermore, neuropathic problems may also result in chronic pelvic pain.
Identifying the exact cause of pelvic pain is often a difficult task because of the number of factors that may contribute to the development of pain. Therefore, uncovering the source and treating the symptoms entails a physician applying the process of elimination. Providing the following information typically helps physicians make accurate diagnoses in regard to pelvic pain:
- What caused the onset of the pain? This involves explaining when and how the pain began. Did it start suddenly after a certain movement? Did it arise after an injury or trauma?
- Where is the pain being felt? The location where pain is being felt helps physicians pinpoint the cause of the pain. For instance, appendicitis is typically characterized by pain that is localized toward the right side of the middle of the abdomen, which is where the appendix is located.
- Is there a pattern? A physician will inquire as to whether the pain is occurring in a predictable manner. For example, if the pain is severe and occurs in periodic bursts or after engaging in a certain activity. If the pattern of pain changes as time progress, this should be mentioned to the physician as well.
- What is the pain duration? The amount of time that pain lasts is also taken into consideration. For example, irritable bowel syndrome may be associated with periodic pain that stops and starts over several months. Pain may also be experienced every day while regular activities are being conducted and then stop abruptly after arriving at home.
- Are there factors that influence the pain? A physician will inquire as to whether any home remedies have been utilized in order to treat the pain and whether or not any of the remedies have been effective. Questions such as whether laying down or eating certain foods worsen pain symptoms will also be asked.
Patients who are suffering from chronic pelvic pain generally undergo a pelvic examination as well as lab tests that aid physicians in making an accurate diagnosis. In cases where the pain is severe or radiates to different areas of the body, additional procedures such as CT scans or ultrasounds may be conducted.
Treatments for Pelvic Pain
Several treatment methods have been established in order to address pelvic pain, but the approach that is utilized typically depends on the pain source. Pain that is not debilitating or severe may be successfully treated by home remedies such as pain relievers, but additional forms of intervention may be necessary for intense and chronic pain.
Common pharmacotherapy methods include non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin; anti-depressants; or oral analgesics such as acetaminophen. Each of these types of medication has been shown to be helpful for relieving pain. Women who have chronic pelvic pain are often administered a medication called gabapentin, which is often used as a treatment for neuropathic pain. If over-the-counter medication does not effectively reduce pain, a physician may recommend opioid medication in order to help manage the pain.
An effective and minimally invasive treatment for chronic pelvic pain is a nerve block. Nerve blocks have been shown to help patients experience significant or even complete relief from pelvic and abdominal pain. This procedure hinders the transmission of pain signals from a network of nerves called the celiac plexus. This nerve bundle is responsible for transferring pain signals from the abdominal region to the brain. In particular, the celiac plexus block involves the injection of anesthesia into the celiac plexus nerve bundle, thereby disrupting pain signal transmission. Evidence also indicates that some patients experience significant pain relief from a procedure known as spinal cord stimulation. This technique involves the implantation of a device close to the spinal column in order to administer electrical impulses that can regulate the transfer of pain signals from spinal nerves to various regions in the body.
An alternative approach that also has the ability to provide pelvic pain relief is called biofeedback training. This form of training teaches patients relaxation strategies and coping techniques that help them reduce their symptoms and control pain.
Pelvic pain occurs in the abdominal or pelvic region and may be periodic or chronic. The pain may be caused by a number of factors and may also extend to different parts of the body depending on the underlying source. Conditions that are associated with the presence of pelvic pain vary from menstrual cramps to appendicitis or even irritable bowel syndrome. There are several effective treatment methods that can be performed according to the types of symptoms that are being experienced. A physician will thoroughly discuss the appropriate form of treatment that should be utilized after making an accurate diagnosis.
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