FAQ’s on Pelvic Pain Treatment in Philadelphia

Any pain that occurs near the pelvic cavity and bone is referred to as pelvic pain. The pelvic bone lies at the juncture of the spine and upper leg bones. Pain of this nature may be associated with bones, organs, joints, nervous tissue, or muscles.

What are the symptoms related to pelvic pain?

Pelvic pain can be mild, moderate or severe, and it may be short-term (acute) or long-term (chronic). This type of pain may radiate (spread) to other body regions, such as the abdomen, lower back, or legs.

How common is chronic pelvic pain?

Researchers estimate that 2-4% of women experience chronic pelvic pain. However, as many as 33% of women report some type of pelvic pain at any point during their lifespan.

What causes chronic pelvic pain?

Pelvic pain can be cause by one condition or a combination of problems. Causes include:
•    Gastrointestinal system disorders – Cancers, inflammatory bowel disease, bowel obstruction, irritable bowel syndrome, and diverticulitis.
•    Reproductive system disorders – These include uterine fibroids, cancer, ovarian growths, endometriosis, chronic pelvic inflammation, dysmenorrhea (painful periods), and injury to the reproductive structures.
•    Urinary system disorders – Interstitial cystitis, kidney stones, chronic infection, and prostatitis.
•    Musculoskeletal system disorders – The joints, nerves, and muscles of the pelvis are often a source of pain. Tissues can be stretched during childbirth, pelvic structures become compressed, or muscles weaken from lack of use.
•    Pelvic myofascial pain (trigger points) – When pain arises from the lower abdominal muscles it is considered myofascial pain. Trigger points are small localized areas of tenderness of the abdominal muscles.
•    Other – Nerve damage, inguinal hernia, fibromyalgia, and dysfunction of the pelvic floor muscles.

How is pelvic pain diagnosed?

Chronic pelvic pain is diagnosed after serious conditions are eliminated. The doctor will take a detailed medical history, conduct an examination, and order several laboratory tests involving blood, urine, and/or tissue. To evaluate for certain conditions, the doctor may order a computed tomography (CT) scan or ultrasound of the pelvis.

How is pelvic pain treated?

Treatment of pelvic pain depends on the underlying cause, the severity and intensity of the pain, and what therapies have worked or failed in the past. Options include:
•    Drug therapy – Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for mild to moderate pain. For chronic pain with nerve involvement, the doctor may prescribe tricyclic antidepressants or anticonvulsants. For severe and extreme pain, the doctor may order opioids short-term.
•    Nerve block – With this minimally invasive procedure, the doctor targets the celiac plexus nerves that supply the pelvic area. Using x-ray guidance, the doctor inserts the needle near the nerves and instills a long-acting anesthetic or neurolytic agent onto the nerves. According to clinical studies, this procedure has an 85-90% success rate.
•    Acupuncture – This ancient Chinese therapy involves insertion of tiny needles into the skin to stimulate endorphin production and restore body energy flow.
•    Trigger point injections (TPIs) – This involves injecting the painful trigger points with lidocaine, which alleviates pain and deactivates the painful contraction.
•    Spinal cord stimulation – For pain that does not respond to other treatments, the doctor can surgical implant a spinal cord stimulator (SCS). The unit demits mild electrical impulses that travel up wires to electrodes, which are surgically fixed near the spinal cord. This promotes pleasant sensations and blocks pain signals. In a recent clinical study, this technique had a 71% efficacy rate.  


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