Causes of Chronic Pelvic pain
Chronic Pelvic Pain is defined as pain in the lower abdomen; lasting for 6 months or longer; and is not exclusively related with menstruation, intercourse, pregnancy or malignancy. The estimated prevalence of chronic pelvic pain is 3.8% among women between the ages of 15-73 years. Approximately 60% of women with chronic pelvic pain never receive a specific diagnosis and 20% never go for further investigation to find the cause of their pain. (Montenegro et al; 2007 Int J Clin Pract, 62, 2 ,263-269).
As a result, chronic pelvic pain has far reaching effects including the breakdown of personal relationships and sometimes even unemployment. Despite the prevalence of chronic pelvic pain, very little is known about the cause of it.
Pelvic pain may arise from any structure in the pelvis including the abdomen.
Some possible causes include:
- Pelvic inflammatory disease
2.) Bowel related
- Irritable bowel syndrome
3.) Bladder related
- Interstitial cystitis
(irritable bladder symptoms like urgency frequency, nocturia-associated with lower abdominal pain which is relieved by micturition)
4.) Musculoskeletal causes
- Mechanical pelvic pain: possibly as a result of trauma; pregnancy or congenital abnormality.
- Myofascial trigger points in the abdominal wall and/or pelvic floor muscles
5.) Nerve related pain
- Neuropathic pain form a damaged nerve
- Nerve entrapment may occur in scar tissue or fascia
6.) Psycho-social factors
Factors like depression, sleep disorders, previous traumatic experiences or physical/sexual abuse can all contribute to chronic pelvic pain. (Moore,J and Kennedy, 2005)
Regardless of the causes of chronic pelvic pain; a holistic approach is taken when addressing this condition.
Look out for our next blog post featuring the role of physiotherapy in assessing and treating chronic pelvic pain.