Fibromyalgia and Pelvic Pain

    What is Fibromyalgia and its Relation to Pelvic Pain?

    Fibromyalgia is a disorder of chronic, widespread pain and tenderness. Fibromyalgia can affect the body as a whole but specifically, can he highlighted in pelvic pain and pelvic floor dysfunction. Patients that are experiencing fibromyalgia and pelvic pain should consult with a specialist because of the complexity of the pelvic floor.

    Pain related to an injury is most often localized, being tied to the injuries area. Fibromyalgia and pelvic pain is diffuse muscle pain, meaning it involves multiple muscles group. Ultimately the pain can be felt throughout several regions in the body including the pelvis, back, hips, legs, stomach and more.

    Because of the nature of fibromyalgia causing chronic and diffuse pain is it associated with central sensitization. The nervous system goes into a state of overdrive simply seen as a persistent state of reactivity.

    Examining for Fibromyalgia and Pelvic PainSince the pain areas are numerous this can evolve into a complex array of other symptoms and conditions. The pain can lead to pelvic floor dysfunction and several other conditions related to urinary incontinence, sexual dysfunction, and others.

    Causes of Fibromyalgia and Pelvic Pain

    Fibromyalgia can be caused by:

    • The Diagnosis of Fibromyalgia
    • Multiple Tender Points Throughout the Body
    • Underlying Central Sensitization
    • Nerve Hypersensitivity
    • Lack of Mobility

    Fibromyalgia Signs and Symptoms:

    • Persistent widespread pain and tenderness for greater than 3 months
    • Fatigue
    • Stiffness
    • Cognitive difficulties
    • Often associated with multiple other unexplained symptoms, such as anxiety and/or depression, function impairments in activities of daily living

    Fibromyalgia and Pelvic Floor Risk Factors

    • Family History/Genes
    • Sensitive Nervous System
    • History of Trauma or Sexual Abuse
    • Gender as it is more common in women

    Diagnosing Fibromyalgia and Pelvic Floor Dysfunction:

    Fibromyalgia is a diagnosis of exclusion and patients must be thoroughly evaluated for the presence of other disorders. If fibromyalgia is left untreated or undiagnosed for an extended period of time it can have a cascading effect on pain and other conditions. Fibromyalgia can highlight pain with the pelvic floor region which can onset pelvic specific conditions. This is often lead to pelvic floor dysfunction or hypertonia. This tightness of the pelvic floor muscles can create tension on the supporting organs further cascading into other conditions around bladder pain, pain with bowel movement, and much more.

    Can Fibromyalgia and Pelvic Pain Be Related?

    Yes, both fibromyalgia and pelvic pain patients have tenderness in their muscles. This pain is often felt over periods of months or even years. Treatment plans have to mirror the timeline of pain. Relief can potentially come from trigger point injections but they will most often be done in succession with extended pelvic floor physical therapy and other supporting treatments.

    Do Chronic Pelvic Pain Dysfunction and Fibromyalgia Share Overlapping Symptoms/Conditions?

    ultrasound guided injections to help treat Fibromyalgia and Pelvic PainYes, patients with either or both conditions have central and peripheral sensitization and have an upregulated nervous system that can contribute to muscle pain.

    Can Fibromyalgia Pelvic Pain Affect Both Men and Women?

    Yes, however, fibromyalgia is more common in women. A 2015 study in PubMed – https://www.ncbi.nlm.nih.gov/pubmed/26259883 –  focused in understanding pelvic floor and urinary distress in women with fibromyalgia. The study drew a strong connection quoted as noting

    “Women with FM report significantly bothersome pelvic floor and urinary symptoms. Fibromyalgia management should include evaluation and treatment of pelvic floor disorders recognizing that pelvic distress and urinary symptoms are associated with more severe FM symptoms.”

    Another study – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927857/ – from 2014 drew on the connection of fibromyalgia and the sexual dysfunction vulvodynia. Over half the women in the study were diagnosed with vulvodynia as a secondary condition to the fibromyalgia. With only one-quarter of the patients with vulvodynia being aware of the diagnosis.

    What Treatment Options Do Patients Have If They Are Experiencing Pelvic Pain With Fibromyalgia?

    Our protocol, which you can learn more about,  in addition to pelvic floor physical therapy and lifestyle modifications, exercise, nutrition, proper medications, and cognitive behavioral therapy are all potential pieces of the individual treatment plan. 

    Meet Pelvic Rehabilitation Medicine

    At Pelvic Rehabilitation Medicine, we treat whole human beings, not symptoms. In the body, everything is connected; and the pelvic region is the vital center of the body’s connected functioning. Our physicians take an innovative approach, combining traditional medicine with holistic modalities and restorative and regenerative medicine. We treat both male and female patients who experience core muscle and nerve problems; chronic pelvic pain; and pelvic floor muscle dysfunction. Learn More »

    Relevant Publications/Citations

    Shrikhande A, Ahmed T, Shrikhande G, Hill C. A Novel, Non-Opiod Based Treatment Approach to Men with Urologic Chronic Pelvic Pain Syndrome (UCPPS) Using Ultrasound Guided Nerve Hydrodissection and Pelvic Floor Musculature Trigger Point Injections. The International Continence Society. 2018 Aug. Link to Article.

    Allyson Shrikhande, MD sits as the chair of the Medical Education Committee for the International Pelvic Pain Society. Link to Medical Committee.

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