What is Pelvic Pain? Transcription

Dr. Shrikhande: Pelvic pain is a complex multifaceted condition, mainly because in the area of the pelvis, there really is quite a bit going on. Issues in the bladder can actually crosstalk and cause issues in the pelvic floor and so on. Pelvic pain can be felt in the lower abdomen, in the lumbar, in the sacral region, the buttocks, and then, of course, the entire pelvic region where it can be felt in something called the perineal area, it can go down their leg, it can radiate up towards the thoracic spine. For men, it can be felt in their penis, in their testicles. For women, it can be felt in their vagina, quite often it can be felt in the bladder, and the urethra, and/or the rectum.

Patients with chronic pelvic pain have sensitization of their nervous system. Their nerves are hyperexcitable or hyperactive, and essentially firing too much. We always start with pelvic floor physical therapy, in addition, we always add daily diaphragmatic breathing, meditation of some patients, we’ll add some craniosacral work, some acupuncture, some medical massage or connective tissue work, and some yoga, depending on the patient. We have patients that come in to see us who have high-stress level jobs and have type A personality and often are sitting the majority of the day.

Dr. Ahmed: Oftentimes, we see a lot of patients who are professional athletes who developed pain from repetitive microtraumas to their pelvic floor.

Dr. Hill: I try to get them out of that state of despair that it’s so easy to get sucked into when you’re suffering day-to-day.

Dr. Ahmed: When they talk to me, they’re usually very tearful and upset because they don’t have anyone to talk to. For those patients, I try to see if I can connect them with another patient with their permission. I also encourage them to find different outlets like Facebook, different organizations.

Dr. Hill: Sometimes it’s just helpful to talk to people who understand and who’ve had the same conditions as you have, and kind of troubleshoot with them things that have worked and to get support.

Dr. Ahmed: I think the most important thing is that patients with pelvic pain should know that they are not alone and that they can find help and support.