Human pelvis is that region which is located in the lowest part of the abdomen. Pain in this region is known as pelvic pain. Pelvic pain is a pain, which though common in women, can also be experienced by men. The pelvic pain is often felt in the lower abdominal region and can radiate towards the back, thighs and legs. It is indicative of an underlying medical condition, which can be mild, such as menstruation; or serious, such as a tumor or ectopic pregnancy. There can be psychogenic reasons, infectious causes, gynecological causes and dysfunction of the other organs, such as intestines, resulting in pelvic pain. Pelvic pain can be sharp or stabbing in nature or dull or crampy in nature. Everything depends on the underlying medical condition causing it. Other than medical history, physical and pelvic exam, different types of tests and investigations need to be carried out to identify the cause behind the pelvic pain. Treatment also depends on the cause. Conservative treatment, such a rest, ice/heat packs, pain killers works for mild pain. However, persistent pelvic pain accompanied by other symptoms, such as vomiting, bleeding, fever etc. should never be ignored. Pelvic pain and any type of pain which persists for more than 3 to 6 months is considered as chronic pain.
In our PELVIC PAIN INFORMATION CENTER we have covered lots of conditions in which we experience pelvic pain, their causes, symptoms, investigations, pathophysiology and treatment. Given below is a brief summary on some of the topics covered under this section. For more topics and a detailed read, please refer to the side menu and read on under our PELVIC PAIN INFORMATION CENTER.
Pelvic pain often occurs in the lower abdominal region. Pelvic pain can be constant or sporadic. Pelvic pain is commonly experienced by women, as a dull pain during their menstruation. Pelvic pain is a symptom of an underlying problem with any of the pelvic organs like uterus, ovaries, cervix, fallopian tubes or vagina. Pelvic pain may also be due to an infection or other problem with urinary tract, lower intestines, rectum, bone or muscle. In males, the common cause for pelvic pain is prostate gland problems. Pelvic Pain is classified into Acute Pelvic Pain and Chronic Pelvic Pain.
Depending On The Cause And Origin Of The Pain, The Pelvic Pain Is Described As:
- Localized Pain.
- Colicky Pain.
- Sudden Onset of Pain.
- Slowly-developing Pain.
- Pain Involving the Entire Abdomen.
- Pain Aggravated by Movement or During Examination.
Causes of pelvic pain are many and include: Inflammation, fibrosis, injury, pressure, inflammation of intraperitoneal regions, muscle contractions, psychogenic factors, ectopic pregnancy, PID-pelvic inflammatory disease, twisted ovarian cyst, ruptured fallopian tube, ovarian cyst rupture, miscarriage, appendicitis, menstrual cramps, endometriosis, endometrial polyps, uterine fibroids and adhesions in the pelvic cavity etc.
Depending on the cause, other symptoms of pelvic pain include: Pain which can be dull to sharp, acute cramping during menstruation, dyspareunia, painful urination or bowel movement, hematuria, hematochezia, menorrhagia, irregular vaginal bleeding, bleeding after intercourse and patient can also suffer from depression.
Treatment is done by treating the underlying cause of the pelvic pain and it includes: Antibiotics, anti-inflammatories, oral contraceptives, physical therapy (PT) and relaxation methods.
Investigations done for pelvic pain are: Medical history, physical exam, pelvic examination, blood tests, urinalysis, pregnancy test, culture of cervical cells, x-ray, CT scan, ultrasound, MRI, laparoscopy, high vaginal swab and FBC.
To read in detail about the types of pelvic pain, their causes, symptoms, pathophysiology, investigations and treatment for pelvic pain, please refer under our side menu where our PELVIC PAIN INFORMATION CENTER is located.
Genitofemoral nerve neuralgia is a common medical condition in which pain is felt in the lower abdomen. This can happen in both females and males. The pain observed is usually unilateral and present over the lower abdomen and pelvic region. Pain occurs rarely bilaterally. Pain can be referred to the groin and inner thigh. Common cause of this condition is pinched nerve in the inguinal canal after the repair of the inguinal hernia.
Genitofemoral neuralgia is a very common source for lower abdominal and pelvic pain. Genitofemoral neuralgia is classified into acute and chronic pain.
Common symptoms include: Pain in the pelvic region and lower abdomen, and pain radiating to the groin and inner thigh. Causes are injury to the groin, inguinal ligament sprain, work injuries, problems in the spinal canal, pelvic abscess/tumor, and after surgery in the pelvic region, numbness in the lower abdomen, anterior abdominal wall weakness. Treatment consists of pain medicines (acetaminophen), NSAIDs (naproxen), topical anesthetics, corticosteroids, opioids (tramadol), antidepressants (Cymbalta), anticonvulsants (Lyrica), TENS unit, cold pack, physical therapy, trigger point injection, psychotherapy, biofeedback, laser therapy etc.
To read more about Genitofemoral Neuralgia and its causes, symptoms, investigations and treatment in detail, Pease refer to our section PELVIC PAIN INFORMATION CENTER on the side menu.
Pain in the perineum or in the perineal region, is known as perineum pain. In males, the region between the anus and testicles is perineum; and in females, the region between the anus and the vagina is perineum. Common causes of perineum pain are: Abscess, prostatitis, trapped pudendal nerve, postpartum perineural cyst ischiorectal abscess, ejaculatory duct obstruction, benign prostatic hypertrophy, femoral hernia, trauma, renal calculi, psychogenic causes, obstructed hernia, urinary tract infection and prostate cancer.
Gynecologic causes for perineal pain include: Ovarian cysts, endometriosis, ectopic pregnancy, pelvic inflammatory disease, ovarian torsion and dysmenorrhea. Abdominal Causes are: Colitis, proctitis and appendicitis. Symptoms depend on the cause of the pain. So, to read about them in detail please refer to our side menu and read under our PELVIC PAIN INFORMATION CENTER.
Treatment mainly depends on the cause and is done by taking bed rest, lots of fluid intake, reduced consumption of alcohol and spicy food. In case of fever, medicines such as antibiotics and antipyretics are started.
Investigations done for perineal pain include: Medical history and physical examination, blood tests, urinalysis and radiological testing.
Pain in the groin region is known as groin pain and it is classified according to its cause:
- Degenerative Inguinal Pain.
- Congenital/Anatomical Inguinal Pain.
- Referred Groin Pain.
- Unilateral Groin Pain.
- Bilateral Groin Pain.
Accompanying symptoms depend on the cause and include: Pelvic pain, fever, warmth and redness surrounding the affected region, lump/bulge in the groin area/ scrotum, difficulty in running, swimming etc., tiredness, sore throat, fever, cough, headaches, loss of appetite, lower back pain, itchiness and pain in the genital region, painful urination, lower abdominal pain, vaginal or rectal discharge, swollen lymph nodes, difficulty in walking, hip muscle weakness.
Serious and life threatening symptoms include: Hematuria, hematochezia, abnormal rectal discharge, mental confusion, dyspnea, dizziness, urinary changes, genital ulcer, severe pain in the abdomen, nausea, scrotal swelling and yellow discharge from vagina or penis.
Causes of groin pain include: Hip arthritis/ fracture, injury to the pelvis, hip, testicles; ligament/ muscle/ tendon strain. Infectious Causes like: Abscess, inflammation of testicle, skin infections, infection in legs and STDs.
Non-Infectious causes are: Allergic reactions, hip arthritis, cancer of testicles/ lymphoma, pinched nerve renal calculi, medication reaction, low back injury, testicular torsions and surgical procedures.
Treatment for Groin Pain depends on the cause and the results of the investigations. Treatment includes: Physical therapy, ice therapy, NSAIDs, local steroid injections, RICE treatment, exercise, massage and manipulation.
Investigations for Groin Pain are: Medical history and physical examination, urine analysis, blood tests, hip x-rays, provocation ultrasound, MRI, ultrasound, MRI arthrography and bone scan.
Other Pelvic Pain Diseases Which are Covered in this Section: