Causes and risk factors:
Chronic pelvic pain is the symptom of some underlying pathology. It can be gynecological, urological, gastro enteric, musculoskeletal or neurological in origin. Endometriosis, pelvic inflammatory diseases, diseases of ovaries like cyst or torsion is the major underlying factors that lead to pain in pelvic region. Gastric or urinary diseases also lead to pelvic pain. Some of them are inflammation of the intestine, anus or rectum, appendicitis, internal hernias or affection of the bladder or urethra (Ureteritis and Cystitis).Pelvic pain may be due to lax pelvic musculature. Adhesions or nerve entrapments .Chronic pelvic pain can also occur without any obvious cause or due to emotional or certain psychological factors.
Clinical presentations:
As the name suggest pain in pelvic region is the major symptom. The type and modality of the pain depends upon the underlying cause.The pain is of dull aching character, cramps and heaviness in felt in pelvic region. Prolonged sitting or standing in one posture or bowel movements or urination can aggravate the complaints. Pain in back and pain during sexual intercourse are the associated symptoms .Other symptoms pertaining to the gastrointestinal or urinary system can also be seen.
Diagnosis and investigations:
Diagnosis is done on the basis of symptoms narrated by the patient and the examination carried out by the gynecologist .Pelvic Ultrasound is the diagnostic investigations for Pelvic pain .Certain other investigations which are recommended to find out the underlying pathology are complete blood count, urine analysis, culture examination, Laparoscopy, CT scan and MRI of the abdomen and pelvis.
Treatment:
Treatments plan depends on identifying the underlying cause.Anti inflammatory drugs, Non steroidal anti inflammatory drugs or hormonal therapy are the main line of treatment in chronic pelvic pain. Local anesthetic injections, nerve stimulation therapy, biofeedback and relaxation therapies along with pelvic floor exercises are effective in combating the pain. In severe cases surgical intervention is necessary-hysterectomy is done.
Other modes of treatment:
The other modes of treatment can also be effective in treating the infection. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.Accupuncture measures have also found to be effective in managing the pain.
