FAQS on Pelvic Pain and Treatment Options in Nashville & Murfreesboro TN

The pelvis is a structure that houses the reproductive and urinary tract organs and structures. For women, pelvic pain is often the result of problems arising in the uterus, ovaries, or bladder. For men, pelvic pain can occur due to problems with the musculoskeletal structures or from prostate illness.

How common is pelvic pain?

Around 10% of all visits to gynecologists are related to pelvic pain. According to the American Academy of Physical Medicine, nearly 15% of American women ages 15 to 50 suffer from chronic pelvic pain. In addition, around half of women with chronic pelvic pain suffer with depression.

What symptoms are associated with pelvic pain?

Pelvic pain occurs suddenly, and can be sharp, shooting, dully, or achy. Acute pain only lasts a short while, whereas chronic pelvic pain last for more than three months. Pelvic pain can be constant or occur intermittently (on and off). In addition, the pain can sometimes radiate to the back, buttocks, and/or thighs.

What conditions are associated with pelvic pain?

Several diseases and conditions can cause pain of the pelvic region. These include problems with the digestive, reproductive, or urinary system, as well as problems from muscles and connective tissue in the pelvic floor. Occasionally, pain occurs from irritation of the nerves in the pelvis. These conditions include:

  • Endometriosis
  • Adenomyosis
  • Mittelschmerz (ovulation pain)
  • Ovarian cysts
  • Uterine fibroids
  • Appendicitis
  • Colitis
  • Crohn’s disease
  • Fibromyalgia
  • Interstitial cystitis

How is pelvic pain treated?

The treatment of pelvic pain depends on the symptoms and the underlying cause. For chronic pelvic pain, options include:

  • Medications – Many medicines are used to treat pelvic pain, such as nonsteroidal anti-inflammatory agents, pain relievers, and tricyclic antidepressants. Oral contraceptives are sometimes used for hormone replacement.
  • Transcutaneous nerve stimulation (TENS) – With this treatment, electrodes connected to a small device are placed on the skin. The unit delivers electrical current to the affected region, which blocks pain signal transmission.
  • Acupuncture – Performed by a skilled practitioner, small needles are positioned into the skin. This produces release of endorphins and relieves pain.
  • Celiac plexus block – With this minimally invasive procedure, the doctor inserts a small needle into the back and positions it near the celiac plexus nerves, which supply the pelvic region. An anesthetic substance is injected near the nerves. The success rate for the celiac plexus block is 85-90%, according to clinical research studies.
  • Sacral nerve stimulation (SNS) – For chronic pelvic pain, and when the patient does not respond to other treatments, the doctor can surgically implant a small device near the nerves that supply the pelvis. This unit delivers electrical current that interferes with pain signal transmission. The success rate for SNS is reported at 71%, according to a recent clinical study.

Resources

American Academy of Physical Medicine (2014). Chronic pelvic pain. Retrieved from: http://www.aapmr.org/patients/conditions/pain/Pages/chronicpelvicpain.aspx

Daniels, JP & Khan, KS (2010). Chronic pelvic pain in women. BMJ, 341. doi: http://dx.doi.org/10.1136/bmj.c4834

Siegel, S, Paszkiewicz, E, Kirkpatrick, C, et al. (2001). Sacral nerve stimulation in patients with chronic intractable pelvic pain. The Journal of Urology, 166(5), 1742-1745

Srivastava, D (2012). Efficacy of sacral neuromodulation in treating chronic pain related to painful bladder syndrome/interstitial cystitis in adults. Journal of Anesthesiology Clinical Pharmacology, 28(4), 428-435.

Vorenkamp, KE & Dahle, NA (2011). Diagnostic celiac plexus block and outcome with neurolysis. Pain Management, 15(1), 28-32. DOI: http://dx.doi.org/10.1053/j.trap.2011.03.001