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.
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
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
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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