Pelvic pain: Diagnosis and treatment

Pain in the pelvis is a symptom that may indicate an underlying abnormal psychoneuromuscular function. Pelvic pain can be acute or chronic. Acute pelvic pain is often experienced after surgery or other soft tissue trauma. If the pain lasts longer than three to six months, it is categorized as chronic pelvic pain. Although pelvic pain is experienced by both men and women, it is more prevalent among women and is usually associated with dysmenorrhea.

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Diagnosis
Pelvic pain can be caused by different conditions, including visceral pain and pelvic girdle pain.
In women, pelvic pain may result from various gynecological conditions such as dysmenorrhea, endometriosis, ectopic pregnancy, ovarian cysts, ovarian torsion, Mullerian abnormalities, and pelvic inflammatory disease. The pelvic pain may also be caused by abdominal problems like appendicitis, colitis, proctitis, and long pain hematuria syndrome.

Chronic pelvic pain in men is called chronic prostatitis. Men with this problem do not have known infections unlike women.

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Treatments
The International Pelvic Pain Society states that chronic pelvic pain is one of the most difficult clinical problems to treat because many patients do not respond to conventional medical or surgical treatment. Doctors who treat patients of chronic pelvic pain must have adequate knowledge about the disorder and must have special skills in physical examination and history-taking in order to uncover all sources of the patient's pain.

Physiatrists like Jung Ahn, Mary Kneiser, and Kathleen Francis are examples of doctors who are trained in treating pelvic pain.

After examining the patient’s medical history, physiatrists conduct diagnostics tests. Men with chronic pelvic pain are usually treated with multimodal therapy, with the goal of relaxing the pelvic nerves. Women may be required to take a pregnancy test, too, before undergoing on a trial of anti-inflammatory medications, hormonal therapy, or neurological agents. In some cases, the chronic pelvic pain can only be treated by the surgical removal of the uterus.

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When planning a consultation with a physiotherapist for chronic pelvic pain, make sure the doctor is licensed and has sufficient training in physical therapy and rehabilitation. Mary Kneiser, for instance, is a physiatrist certified by the American Board of Physical Medicine and Rehabilitation. Learn more about her practice at www.abilityassessments.com.