Chronic Pelvic Pain – Causes, Symptoms and Treatment

Chronic pelvic pain refers to pain in the region between your hips, below your bellybutton. In order to be considered chronic, the pain must last for at least six months or longer.

What are possible causes of chronic pelvic pain?

Endometriosis: Endometriosis is a problem with the lining of the uterus. Tissue from the lining of the uterus moves through the fallopian tubes and gets on your ovaries, in your pelvis, on your bladder or in other areas. When you have your period, this tissue swells and bleeds, just like the lining of your uterus. This is often painful, and scar tissue can form in your pelvic area.

Tension in your pelvic floor muscles. Spasms or tension of the pelvic floor muscles can lead to recurring pelvic pain.

Chronic pelvic inflammatory disease. This can occur if a long-term infection, often sexually transmitted, causes scarring involving the pelvic organs.

Pelvic pain can be caused by an infection or inflammation. An infection doesn't have to affect the reproductive organs to cause pelvic pain. Pain caused by the bladder, bowel, or appendix can produce pain in the pelvic region; diverticulitis, irritable bowel syndrome, kidney or bladder stones, as well as muscle spasms or strains are some examples of non-reproductive causes of pelvic or lower abdominal pain.

What are the signs and symptoms of PID?

Symptoms of PID vary from none to severe. When PID is caused by chlamydial infection, a woman may experience mild symptoms or no symptoms at all, while serious damage is being done to her reproductive organs. Because of vague symptoms, PID goes unrecognized by women and their health care providers about two thirds of the time. Women who have symptoms of PID most commonly have lower abdominal pain.

Myofacial Trigger Points: Chronic pain can be created by spasm of the muscles that line the pelvis. On pelvic examination, there may be tenderness and tightness in particular muscles. Experts in anesthesiology and pain management specialize in relieving this type of pain.

Chronic Pelvic Pain Health Centre Treatment

One of the first steps in relieving your pain will be to treat the conditions that underlie it. Information about treating endometriosis, pelvic inflammatory disease and adhesions, irritable bowel syndrome, interstitial cystitis, depression and back pain can be found elsewhere on this site.

Antidepressants. Antidepressants can be helpful for a variety of chronic pain syndromes. Tricyclic antidepressants, such as amitriptyline, nortriptyline (Aventyl, Pamelor) and others, seem to have pain-relieving as well as antidepressant effects. They're commonly used for chronic pain control even in people who don't have depression.

Surgery for chronic pelvic pain

Laparotomy is a surgical procedure that is done by making an incision in the lower abdomen. This allows the surgeon to see and inspect the abdominal cavity for structural problems, sites of endometriosis (implants), and scar tissue (adhesions). The surgeon can then remove implants and adhesions. The surgeon can also correct structural problems that interfere with an organ's normal function, such as removing adhesions from the bowel wall.