“What can I do for my chronic pelvic pain?”

Definition of Chronic Pelvic Pain

Non-cyclic pain of 6 or more months duration that localizes to the anatomic pelvis,  abdominal wall at or below the umbilicus, lumbosacral back or the buttocks and is sufficient severity to cause functional disability or lead to medical care.

From a Physical Therapy perspective, patients who have chronic pain have often been under or over treated, yet have not received appropriate neuro-musculoskeletal care.

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Diagnoses Associated with CPP

  • Interstitial Cystitis
  • Dyspareunia—painful irritation
  • Musculoskeletal Dysfunction
  • Endometriosis

 

Signs and Symptoms

  • Abdominal wall pain and adhesions
  • Decreased delay in urinations
  • Frequency– increased urination
  • Negative Urine Culture
  • Pain/discomfort; pelvic, bladder, perineal, rectal

 

Causes of CPP

  • Pain with intercourse
  • Trauma: childbirth, sexual abuse, repetitive minor trauma, sports
  • Deconditioning/Disuse
  • Muscle Incoordination/spasms
  • Musculoskeletal mal-alignment

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Why We Care

Pain problems that are recurrent, becoming chronic, or do not respond to usually effective treatment should be checked for :

  • Muscular components
  • Multi-organ involvements
  • Nervous system changes
  • Emotional factors
  • Relationship factors

sad lady

 

 

 

 

Physical Therapy Treatment 

Pelvic floor physical therapy is highly effective in the treatment of chronic pelvic pain! Best of all, most insurances cover this type of therapy!

  • Pelvic floor exam: assessing pelvic floor muscle tone, strength, coordination, tend/trigger points, prolapse, pelvic descent
  • Neurological, musculoskeletal, abdominal exam
  • Pelvic floor training and exercise
  • Myofascial release techniques
  • Neuromuscular re-education
  • Internal/External Ultrasound
  • Heat/Cold Therapy
  • Muscle energy techniques

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Published by Dr. Cora T Huitt

Cora T. Huitt, PT, DPT, BCB-PMD ~Thirty seven years of clinical practice, specializing in women's health for fifteen years. ~BS Degree in Allied Health Professions, Ohio State University, '72. ~Master of Arts in College Teaching (MACT) focus in Physical Therapy & Therapeutic Exercise, University of North Carolina, '76. ~ Doctorate of Physical Therapy, Alabama State University, 2010 ~Attended multiple courses offered in Women's Health Physical Therapy, including Pelvic 1, 2, 3 Course in Women's Health Section APTA. ~Member of VPTA and APTA, Women's Health Section. ~BCIA-PMDB Biofeedback- Pelvic Muscle Dysfunction Biofeedback. ~Certified Pilates instructor, ProHealth. ~Affiliate member of the American College of Obstetrics and Gynecology. ~Member of International Continence Society. ~Member of National Vulvodynia Association. ~Adjunct Clinical Faculty for student affiliation at multiple universities. ~Director of APTA Women's Health Residency since 2007, credentialed in 2008. (only other residency at Duke Unviersity)

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