Pelvic pain: Chronic

Published on 10/03/2015 by admin

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Chapter 27 PELVIC PAIN: CHRONIC

Chronic pelvic pain is defined as noncyclic pelvic pain that has lasted 6 or more months. The additional requirement of severity enough to cause functional disability or to necessitate medical or surgical treatment is often used in the definition. Pelvic pain may refer to pain that localizes to the pelvis, lower abdominal wall, lower back, or buttocks. About 15% to 20% of 18- to 50-year-old women suffer from chronic pelvic pain.

The most common causes of chronic pelvic pain are endometriosis, interstitial cystitis, adhesions, and irritable bowel syndrome. In addition, there is a strong association between chronic pelvic pain and a history of physical or sexual abuse.

The cause of chronic pelvic pain is often not discernible even after thorough evaluation. In addition, there may be several associated conditions that contribute to the pelvic pain. Disorders of the reproductive tract, gastrointestinal system, urologic organs, musculoskeletal system, and neurologic system, as well as psychologic factors, may be associated with chronic pelvic pain in women. On occasion, only one of these disorders is present, and treatment is curative. More often, however, the pain is associated with several diagnoses, and a number of contributing factors necessitate evaluation and treatment.

Causes of Chronic Pelvic Pain

Gastrointestinal

Chronic intermittent bowel obstruction

Diverticular disease

Inflammatory bowel disease

Irritable bowel syndrome

Gynecologic

Musculoskeletal

Abdominal wall pain

Chronic coccygeal pain

Compression fracture

Degenerative joint disease

Disk herniation

Muscle strain or sprain

Neuralgia of iliohypogastric, ilioinguinal, or genitofemoral nerves

Pelvic floor myalgia

Piriformis syndrome

Rectus tendon strain

Spinal cord or sacral nerve cancer

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