What is pelvic pain?
Pelvic pain refers to pain in the region of women’s internal reproductive organs. Pelvic pain may be a symptom of infection or may arise from pain in the pelvic bone or in non-reproductive internal organs, such as the bladder or colon. While pelvic pain is most prevalent in women, it can occur in men, too.
What causes pelvic pain?
There are many different causes of pelvic pain, including infection, ectopic pregnancy, ovarian cysts, and endometriosis. A common type of pelvic infection is pelvic inflammatory disease (PID). PID is an infection of the uterus, ovaries, or fallopian tubes and may be caused by sexually transmitted disease. Infections of the kidneys, bladder, or urethra can also cause pelvic pain. If an infection is suspected, treatment with antibiotics is necessary in order to alleviate this type of pelvic pain.
Pelvic pain can also be neuropathic. It is extremely important to establish an accurate diagnosis because some of the causes for pelvic pain can be reversible. The diagnosis is usually made by an OB/GYN and involves pelvic examination, lab testing, and ultrasounds or CT-scans of the abdomen and pelvis.
You might describe your chronic pelvic pain in one or more of the following ways:
- Severe and steady pain
- Pain that comes and goes
- Dull aching
- Sharp pains or cramping
- Pressure or heaviness deep within your pelvis
In addition, you may experience:
Pain during intercourse
Pain while having a bowel movement or urinating
Pain when you sit for long periods of time
Physical therapy for pelvic pain can include pelvic floor muscle training, hot and cold applications, ultrasound therapy, and stretching. Biofeedback is a technique in which a person learns to control pain through thoughts. It can be very helpful for treating pelvic pain. A licensed therapist can teach biofeedback, relaxation techniques, and guided imagery, all of which are very effective techniques in controlling chronic pain.
Neuropathic pelvic pain responds very well to various nerve blocks. Nerve blocks are determined by location of pelvic pain and symptomatology. Another type of nerve block used to treat pelvic pain is an ilioinguinal nerve block, especially useful in treating pain in the lower pelvic region and groin. For pelvic pain that does not respond to more conservative treatment modalities, a spinal cord stimulator may be beneficial.
Spinal cord stimulation
Spinal cord stimulation (SCS) is often described as a “pacemaker for pain” and uses groundbreaking technology that works by introducing an electrical current into the epidural space near the source of chronic pain impulses.
Under a local anesthetic and minimal sedation, your doctor will first place the trial SCS leads into the epidural space. The SCS lead is a soft, thin wire with electrical leads on its tip and it is placed through a needle in the back into the epidural space. The trial stimulator is typically worn for five to seven days as the lead is taped to your back and connected to a stimulating device. If the trial successfully relieves your pain, you can decide to undergo a permanent SCS if desired.
Treatment is based on the underlying cause and can include medications, physical therapy, biofeedback, and nerve blocks.