Pelvic pain in women is a debilitating condition that impacts their ability to undertake daily activities, work or study, and exercise. Studies show the prevalence of pelvic pain in the female population worldwide could be as high as 24%, comparable to rates of those with asthma or back pain. Despite its prevalence and its impact on quality of life, many women are slow to seek help in managing their pelvic pain, with one in three reporting they believe there is nothing that can be done for pelvic pain. So, let’s demystify pelvic pain and look at what it is, how it might feel, what may be causing it, and how it is diagnosed, treated, and managed.
What is Pelvic Pain?
The pelvic cavity is located beneath the abdominal cavity and is easily landmarked by beginning at your belly button and extending down to your groin. The pelvic cavity contains organs, muscles, bones, nerves, and blood vessels. Pelvic pain is felt anywhere within the pelvic cavity and can also radiate to surrounding areas such as the legs and back. It can be sharp, dull, or achy. Pelvic pain can be categorised into acute (sudden and severe) or chronic (lesser severity that comes and goes over six months or longer).
Determining the cause of pelvic pain can be tricky, as pelvic pain can originate from one or more of the organs or structures contained within the pelvic cavity. In some cases, pelvic pain may be psychological in origin and felt when no physiological source is present. What’s more, two people’s experiences of pain are never the same. Even with the same physiological or anatomical cause of pelvic pain, how it is experienced from one woman to another is very individual.
What are the common causes of Pelvic Girdle Pain?
The causes of pelvic pain can be broken down into four categories.
Gynaecological Causes
Urological Causes
Gastrointestinal Causes
Musculoskeletal Causes
Please note this list is comprehensive but not inclusive of all possible causes of pelvic pain. While most causes of pelvic pain are not serious or life-threatening, there are a few conditions that do require emergency treatment, such as appendicitis, peritonitis, ruptured ovarian cyst, ectopic pregnancy, or miscarriage.
In the event you have severe pain, with unexpected vaginal bleeding, or systemic signs of infection such as a fever, you should seek urgent medical attention.
What does Pelvic Pain feel like?
Pelvic pain varies in intensity, location, and presentation from person to person. Common words and phrases used by women to describe their experience of pelvic pain include:
Sometimes the reported pain was isolated to one area or side of the pelvis; other times, it was generalised and covered the majority of the pelvic cavity.
The bottom line is that every woman’s experience of pelvic pain is individual. However, the common experience most of these women share is that pelvic pain is uncomfortable, impacts lifestyle choices, and is largely not discussed, often leaving women experiencing pelvic pain feeling isolated and helpless.
How is Pelvic Pain diagnosed?
The diagnosis of pelvic pain is broken down into three parts. History taking, physical exam, and imaging and diagnostic testing. Together, this information provides a picture of what may be causing a woman’s pelvic pain. This information can then be used to inform treatment and management options.
History Taking
A medical practitioner will ask questions to gather information about the presentation of pelvic pain. These may include things like:
Physical Exam
During a physical exam, a medical practitioner will feel the pelvis and abdomen for any tenderness, swelling, or abnormalities that may be causing pelvic pain. They may also gain consent to do an internal exam of the structures of the pelvis and examine any areas surrounding the pelvic cavity that may also be involved.
Imaging and Diagnostic Tests
The medical provider may also order diagnostic tests such as blood, urine, or stool samples to help them in their diagnosis. Imaging of the structures of the pelvis, such as ultrasound, CT scan, or MRI, is also common. In some cases, a laparoscopy may be recommended. This is an internal form of imaging where a small incision is made into the abdomen; then, a camera is inserted to look for abnormalities in the structures and organs of the pelvis.
How is Pelvic Pain treated and managed?
One in three Australian women incorrectly believe that nothing can be done for pelvic pain. With accurate assessment and diagnosis of pelvic pain, there are, in fact, many treatment and management options.
Depending on the aetiology of pelvic pain, treatment may include:
Physiotherapy is particularly effective in managing chronic pains. A pelvic floor physiotherapist is trained in assessing the structures of the pelvis, assessing your pelvic floor strength and where appropriate, using manual therapy techniques to release tight muscles or joints and giving exercise programs to help you continue to improve.
Key Points on Pelvic Pain
Other conditions related to pelvic pain
The Takeaway Message
Pelvic pain is a prevalent problem affecting women of all ages. The pelvic bowl contains many different structures and organs and as such there can be many different causes of the pain. An accurate diagnosis is essential in identifying the source of your pain. Seeing a women’s health physiotherapist is often required to treat your pains. No one needs to miss out on work, hobbies, or time with loved ones due to crippling pelvic pain – so make a choice not to suffer alone – there is light at the end of the tunnel!
To learn more about what our women’s health physios do, click here.