Chronic Pelvic Pain

Patient education

Chronic Pelvic Pain (CPP) is one of the most common and disabling medical problems.

CPP is any pelvic pain lasts for more than 6 months. Many times, the problem that originally caused the pain has lessened or even gone away completely, but the pain continues. This makes it much more difficult to find the cause of the pain and to provide treatment.

The pain may be in the lower abdomen, the vulva/vagina, the perineum, the anus, or the tailbone. Males can have pain in the lower abdomen, perineum, penis, testes, anus or tailbone. In both women and men, low back pain often occurs. Bladder, bowel, sexual pains and changes in function of these organs are common.

Women and men with this condition will often have experienced the following:

• Pain present for 6 months or more
• Conventional treatments have not relieved the pain or have given only small relief
• The pain is stronger than would be expected from the injury/surgery/condition which initially caused the pain
• Difficulty sleeping or sleeping too much, decreased appetite, "slow motion" body movements and reactions, and other symptoms of depression
• Anxiety and helplessness commonly occur
• Decreased physical activity level

Changes in how she/he relates in their usual roles as spouse, parent, grandparent and employee.

CPP is a combination of physical symptoms

• Pain
• Trouble sleeping
• Loss of appetite.

Psychological symptoms

• Depression
• Anxiety

Changes in behavior

• Change in relationships due to the physical and psychological problems

Pain gate

Our brain decides how much pain we feel or perceive

There is often little or no link between pain intensity and damage

Through pain management, people with chronic and persistent pain are able to normalize and control their pain system.

Physical therapy for CPP

You may be referred to a physical therapist for an in-depth evaluation. A Physical Therapist will do various examinations to look for abnormalities and to find muscle strength, tenderness, length and flexibility. Evaluations will include a thorough review of your medical history, and questions about your eating, drinking, urinating and sexual habits as they relate to your symptoms. Your posture, hip, abdominal and pelvic floor muscles will be assessed for contributing factors such as weakness, tightness, or strain. This may include an external as well as internal exam.

You will then receive a program of physical therapy using various techniques such as:

• Manual Therapy
• Biofeedback
• Electric Stimulation
• Special therapeutic exercises for specific muscles
• Relaxation and breathing techniques
• Behavioral techniques
• Postural education and functional training
• Pelvic Floor training
• Myofascial release techniques for tender spots