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    Pelvic Pain

    Dr. Francis McDonnell Deaconess Comprehensive Pain Centers 09/04/2015

    Pelvic pain, especially among women, is a common condition that can significantly impact the quality of your life. Pelvic pain has numerous causes, which also means that there are numerous treatments available, depending on the cause and type of pain.
     
    What causes pelvic pain?
    Pelvic pain is often caused by medical conditions involving:

    • Reproductive organs (uterus, ovaries, etc.)
    • Urinary tract (bladder)
    • Gastrointestinal tract (digestive system)
    • Lower abdominal muscles, ligaments and connective tissue.

     
    Pelvic pain can be both short-term and long-term, ranging from mild to severe. It typically is worse while sitting and can then cause additional pain during sex, while urinating, while having bowel movements, and in men can present as testicular pain. We admit that experts don’t understand all of the possible causes of pelvic pain yet, but while we search for clear causes, patients can still receive treatment for pain.
     
    How is pelvic pain diagnosed?
    Because of the variety of causes of pelvic pain, there may be several things needed to help diagnose the specific cause or causes:

    • A physical exam
    • Imaging (x-ray, CT scan, etc.)
    • Diagnostic procedures, such as a nerve block
    • Extensive medical history

    Because pain has so many causes, and can even have more than one at the same time, we need to be sure what needs to be treated.
     
    How is pelvic pain initially treated?
    Pelvic pain, especially in women, is usually best managed using a multidisciplinary approach.
    Specialists and therapists on the team should include:

    • OB/GYN physician. This is the first and most appropriate step in diagnosing and managing pelvic pain. An OB/GYN will help rule out tumors, cysts, endometriosis, and other treatable/curable options. A referral is needed to come to the Deaconess Comprehensive Pain Center, and the OB/GYN can provide that.
    • For men, they should consult with their primary care provider. He or she can also rule out treatable/curable options; if needed, they can provide the referral to the Deaconess Comprehensive Pain Center.
    • Physical Therapist - physical therapy also plays an important role in managing your pain. Deaconess Comprehensive Pain Center partners with Progressive Health at Deaconess for pain management. High Pointe Therapy at The Women’s Hospital has a special focus on pelvic pain in women. For more information about High Pointe, visit http://phrehab.com/high-pointe.php
    • Here at Deaconess Comprehensive Pain Centers, we offer comprehensive pain management services utilizing the knowledge and skills of Anesthesiologists, Physical Medicine & Rehabilitation physicians, physical therapists, psychologists, social workers, nurses and pharmacists.

     
    Pelvic Pain Treatment at Deaconess Comprehensive Pain Center
    Once other treatment options have been either utilized or ruled out then a referral to Deaconess Comprehensive Pain Center is needed. At that point, patients will be evaluated by our physicians, and we will determine the most appropriate course of treatment.
     
    Procedures/treatments can include:

    • Superior hypogastric ganglion nerve block. This block is both diagnostic and therapeutic.  It helps identify and relieve pain in the lower abdomen, vulva, perineum, rectum, inner thigh, etc.
    • Femoral nerve block. Helps with groin pain, as well as burning/pain in thigh. It also helps restore pain in the affected limb.
    • Ilioinguinal nerve block. This addresses groin pain and lower abdomen/pelvic pain.
    • Genitofemoral nerve block. This nerve is often damaged during c-sections or other abdominal surgeries. This block can relieve pain in that area.
    • TAP catheter. This can help with abdominal, pelvic and even testicular pain.
    • Ganglion impar. This injection addresses tailbone pain, and sometimes rectal/vaginal pain.
    • Pudendal nerve block. This can be for rectal, perineal or vaginal pain. Pudendal pain is often experienced by bicyclists, horseback riders, and truck drivers.

     
    There are instances in which chronic pelvic pain conditions may not respond to treatments outlined above. In these instances, we may consider an implantable spinal cord stimulator, which interrupts the pain signal.
     
    Don't let pain hold you back. We offer each patient an individualized treatment program. Learn more about our expert staff and other pain management services by calling 812-450-PAIN or visit us online www.deaconess.com/pain.

     

     

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