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Why do I hurt and what is chronic pelvic pain?

Updated: Dec 20, 2023

Chronic pelvic pain is defined as pain in the area below your bellybutton and between your hips that lasts six months or longer.

Chronic pelvic pain can have multiple causes. It can be a symptom of another disease, or it can be a condition in its own right.

Chronic Pelvic Pain  is a medical condition that affects women and men. Pelvic pain typically is associated with combinations of various symptoms. These symptoms may include: sexual pain, vulvar pain, lower abdominal bloating, irritable bowel issues, urinary frequency/urgency, lower back pain, abdominal issues, and  vulvar pain (itching and burning). 

pelvic pain symptoms

Conditions often associated with pelvic pain include: Chronic Pelvic & Sexual Pain Conditions: Interstitial Cystitis (IC), pelvic floor prolapse and/or dysfunction; Pelvic Inflammatory Disease, Dyspareunia, Prostatitis, Lower Urinary Tract Symptoms (LUTS), Vulvodynia, Vestibulodynia, Vestibulitis, Lichen Sclerosus, Endometriosis, Irritable Bowel Syndrome (IBS),Prostatitis, Priapism, Persistent Genital Arousal Syndrome, overactive bladder, Fibromyalgia, chronic fatigue syndrome, vulvar and gynecologic cancers, and chronic pelvic pain. Pelvic, sexual and genital pain can appear suddenly after a trauma, accident or after surgery.  Women can develop chronic pain within the pelvic region after labor and delivery due to trauma to the pelvic floor, pelvic organ prolapse or surgery complications to the muscles and nerves from c-section surgery.  Pelvic pain can also occur after scar tissue (adhesions) forms at surgery wound sites, from damage to nerve, muscle or tissues within the pelvic floor. Pelvic pain can occur after mesh surgery within the pelvic region.

Figuring out what's causing your chronic pelvic pain often involves a process of elimination because many different disorders can cause pelvic pain.

In addition to a detailed interview about your pain, your personal health history and your family history, your doctor may ask you to keep a journal of your pain and other symptoms.

Tests or exams your doctor might suggest include:

  • Pelvic exam. This can reveal signs of infection, abnormal growths or tense pelvic floor muscles. Your doctor checks for areas of tenderness. Let your doctor know if you feel any discomfort during this exam, especially if the pain is similar to the pain you've been experiencing.

  • Lab tests. During the pelvic exam, your doctor may order labs to check for infections, such as chlamydia or gonorrhea. Your doctor may also order bloodwork to check your blood cell counts and urinalysis to check for a urinary tract infection.

  • Ultrasound. This test uses high-frequency sound waves to produce precise images of structures within your body. This procedure is especially useful for detecting masses or cysts in the ovaries, uterus or fallopian tubes.

  • Other imaging tests. Your doctor may recommend abdominal X-rays, computerized tomography (CT) scans or magnetic resonance imaging (MRI) to help detect abnormal structures or growths.

  • Laparoscopy. During this surgical procedure, your doctor makes a small incision in your abdomen and inserts a thin tube attached to a small camera (laparoscope). The laparoscope allows your doctor to view your pelvic organs and check for abnormal tissues or signs of infection. This procedure is especially useful in detecting endometriosis and chronic pelvic inflammatory disease.

Finding the underlying cause of chronic pelvic pain can be a long process, and in some cases, a clear explanation may never be found.

With patience and open communication, however, you and your COPE PT can develop a treatment plan that helps you live a full life with minimal discomfort.

Pelvic physical therapy can treat this issue with stretching exercises, massage and other down-training relaxation techniques to improve your chronic pelvic pain. I can assist you with these therapies and help you develop coping strategies for the pain.

Dr. Ijeoma Nwankpa, PT, DPT, WCS

Let’s talk and start your journey to pelvic excellence!


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