Chronic Pelvic Pain

Chronic Pelvic Pain

1 in 4 women will experience chronic pelvic pain (CPP). Pelvic pain often is very complex and involves multiple systems including the urinary, gastrointestinal, gynecologic, and muscular systems. Likewise, the clinical presentation of chronic pelvic pain can include a hypersensitive nervous system, hyperalgesia, pain in multiple regions, fatigue, insomnia, mood disorders, and memory difficulties.   

Although there can be many causes and factors involving pelvic pain, it has been found that 22% of those with CPP have musculoskeletal causes. Physical therapists are the leading experts in treating musculoskeletal dysfunctions, and pelvic floor physical therapists are highly skilled in assessing how the musculoskeletal system is contributing to chronic pelvic pain. The following are the Chronic pelvic pain diagnoses that benefit from physical therapy:
  • Interstitial Cystitis (Bladder pain syndrome)
  • Dyspareunia 
  • Pelvic Floor Hypertonus 
  • Vulvodynia/Vestibulodynia
  • Vaginismus 
  • Endometriosis
  • Post-op Abdominal Pain/pelvic pain
  • Scar Restrictions and Adhesions
  • Coccydynia


References:
  1. Gyang, A., Hartman, M., & Lamvu, G. (2013) Musculoskeletal causes of chronic pelvic pain: what a gynecologist should know. Obstet Gynecol. Mar;121(3):645-50
  2. Nyggard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008; 300(11): 1311-1316
  3. Weijenborg PT, Greeven A, Dekker FW, Peters AA, Ter Kuile MM, Clinical course of chronic pelvic pain I women. Pain, 2007; 132(suppl 1):S117-S123
  4. McDonald EA, Gartland D, Small R, Brown SJ. Dyspareunia and childbirth: a prospective cohort study. BJOG 2015; DOI: 10.1111/1471-0528.13263. 
  5. Vandyken, C. & Hilton, S. Physical Therapy in the Treatment of Centeral Pain Mechanisms for Female Sexual Pain. Sex Med Rev 2016; 1-11. 
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