The reason for the development of chronic pelvic pain (CPP) can be cyclic or noncyclic, variable or constant.
Several different conditions can lead to the development of the chronic pelvic pain.
The source of the pain is classified into various categories: Gynecologic, Gastrointestinal, Urologic, Musculoskeletal, and Psychosocial.
Conditions Responsible For The Development Of Chronic Pelvic Pain:
Endometriosis, adenomyosis, adnexal lesions (ectopic pregnancy, ruptured corpus luteum cyst, a uterine rupture or ovarian masses), pelvic inflammatory disease (PID), primary dysmenorrhea, fibroids, pelvic neoplasm, pelvic adhesions and pelvic congestion syndrome are the conditions responsible for chronic pelvic pain.
The lower gastrointestinal (GI) tract infections can lead to the development of chronic pelvic pain. This is because the visceral innervation of both pelvic region organs and lower GI tract is same.
Irritable Bowel Syndrome is primarily responsible for the development of chronic pelvic pain. Depression and anxiety are more common in patients who acquire IBS-related chronic pelvic pain.
Inflammatory bowel syndrome (Crohn’s disease, ulcerative colitis), chronic appendicitis, peptic ulcers, hernias, and gastroenteritis are some gastrointestinal conditions that result in the development of chronic pelvic pain.
Urinary tract infection is the most primary urologic source of chronic pelvic pain development. According to recent researches, interstitial cystitis is also a main source for the development of chronic pelvic pain. Kidney stones, urinary tract infection and urethral syndrome are other urologic conditions that lead to the development of chronic pelvic pain.
The mechanical stress of leg-length discrepancy, a musculoskeletal condition with muscle tone enlargement on muscles, ligaments, and joint capsules can result in the development of chronic pelvic pain. Furthermore, the chronic pelvic pain can develop from diseases of the hip, spine, or other muscles.
The sources of chronic pelvic pain can also involve psychosomatic conditions having certain bodily functions and sensations. Moreover, temporary/permanent pressures can also result in manifestations of pelvic pain. Lifestyle is also one of the primary sources of chronic pelvic pain.
Determining the source of the chronic pelvic pain helps the doctor to diagnose and treat the condition successfully.
How To Evaluate And Manage Chronic Pelvic Pain?
Owing to huge number of sources for the development of chronic pelvic pain, numerous tests are needed to evaluate the condition. Physical examination is most essential, particularly the abdomen and pelvis, to evaluate the source of chronic pelvic pain.
The need for laboratory tests depends on the outcome of the physical examination. A laboratory test initially involves a blood test, urine test, test for the presence of sexually transmitted diseases, and a pregnancy test.
Ultrasound imaging, intravenous pyelography (IVP), magnetic resonance imaging (MRI), computed tomography (CT), barium enema and laparoscopy are also recommended to evaluate the severity of the pain.
The chronic pelvic pain treatment is possible only by determining the underlying cause of the condition. However, the pelvic pain can be managed through NSAIDs. No matter what the cause is, the physician provides suitable NSAIDs for symptomatic relief.
Applying heat to the abdomen, regulating bowel movements, and certain exercises also works effectively in providing symptomatic relief.
As the source of the chronic pelvic pain is must for an appropriate treatment, evaluate the source accurately to minimize the effects of the pain!