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Pelvic Pain
'Pelvic Pain' is the pain in the pelvis or lower abdomen area. Most women experience pelvic pain at some time or the other, during their lives. Many times pelvic pain is just due to the normal functioning of the reproductive or other organs. At other times, pelvic pain may indicate a serious problem that needs urgent treatment.
Causes of Pelvic Pain
Many organs are present in the pelvis, including the uterus, ovaries, fallopian tubes etc. The bladder and intestine, and appendix also exist next to the reproductive organs, and sensations from these organs can also feel like pain from the uterus or ovaries.
Sometimes, the pain from the kidneys and pain from muscles and from the abdominal wall can also seem to come from the pelvis.
Pelvic pain is a complex health issue that may be give rise to other health problems. Reporting the correct location, severity and duration of the pain will help your physician reach a correct diagnosis. Women with a retroverted uterus, uterine prolapse or vaginal-vault prolapse may also experience pelvic pain as one of the symptoms.
Nearly 15% (2 in 7) of American women between the age of 18 - 50, suffer from chronic pelvic pain. This condition is often not diagnosed or misdiagnosed. Chronic pelvic pain lasts for more than six months.
Symptoms of Pelvic Pain
The symptoms of chronic pelvic pain may vary from person to person. Some of the symptoms are :
- Pain that lasts for 6 months or more
- No relief or little relief with usual treatment
- The amount of pain may be greater when compared to the amount of tissue damage found by the usual diagnostic test
- Physical activity becomes limited
- The patient may show signs of depression in the form of sleep disturbances, constipation, loss of appetite, slow movement or slow reactions.
Diagnosis of Pelvic Pain
Diagnosis of chronic pelvic pain begins with a thorough evaluation of the patient. This includes a detailed medical history and physical examination that may take several appointments. A detailed history will give the doctor better information that may be used to determine an accurate diagnosis and treatment plan.
A physical examination may go beyond the usual gynecology exam. The pelvis is the central part of the body's support system. The patient's entire body will be examined including her posture and gait, back and abdomen, thighs and upper legs. The patient's skin sensation, any areas of numbness or tenderness may also give clues regarding pain.
The areas around the vagina and rectum will also be evaluated to look for areas of pain. The patient may be asked to tense and relax specific pelvic and abdominal muscles that may aid in the process of diagnosis.
Tests such as blood test, x-rays, ultrasound, CAT scans or MRI exams may also be used. Pain mapping, may also be done.
Treatment :
Treatment for chronic pelvic pain includes an individualized plan based on the patient and may need to be performed over a period of time. Some treatment options include:
- Medications that provide temporary relief while other therapies are tried. These may be used in combination with other medications like anti-depressants or anti-inflammatory drugs.
- Physical therapy may be used to strengthen and stretch certain muscles. Muscle or nerve stimulators may also be used to help with muscle retraining or to block pain sensations. Biofeedback, relaxation and breathing exercises may also prove useful.
- Psychological evaluation and therapy may also be done as a part of a comprehensive treatment plan.
- Surgery may be required in some cases to evaluate pain, to remove pelvic adhesions or endometriosis.