Pelvic Pain Management

Pelvic Pain is felt in lower abdomen, lower back, and the perineum (the area that touches a chair during sitting).

These include chronic pain in the abdomen, between the rib cage and pelvis.

When it presents as an acute pain, it can be an emergency, but the pains seen in a pain clinic are chronic. They can be colicky, coming in spasms or be continuous.

What is Pelvic Pain?

Pelvic pain is discomfort or pain that occurs in the lower abdomen, pelvis, or perineum (the area between the anus and genitals). It can be acute, meaning it comes on suddenly and lasts for a short period of time, or it can be chronic, meaning it persists over a longer period of time. Pelvic pain can be a symptom of a variety of conditions, including reproductive, digestive, and urinary disorders, as well as musculoskeletal problems and psychological conditions.

Pelvic pain can be caused by a number of factors, including infections, inflammation, structural abnormalities, endometriosis (a condition in which tissue that normally lines the uterus grows outside of it), and disorders of the digestive, urinary, or reproductive systems. In some cases, the cause of pelvic pain is unknown.
Treatment for pelvic pain will depend on the underlying cause. It may include medications, physical therapy, and in some cases, surgery. It is important to see a healthcare provider if you are experiencing persistent or severe pelvic pain, or if it is accompanied by other symptoms, such as abnormal vaginal bleeding, fever, or pain during urination.

Causes Of Abdominal & Pelvic Pain :

Abdominal pain can arise from visceral diseases like appendicitis, cholecystitis, pancreatitis, infections such as tuberculosis, and cancer of internal organs.
Pelvic pains arise from the pelvic organs such as the terminal intestine, rectum, urinary bladder, uterus and ovary. Other pelvic and abdominal pains may be neuropathic in origin, arising after surgeries for hernia, gallbladder, pancreas etc.

Current Management and Outcomes:

Chronic abdominal and pelvic pains are difficult conditions to treat. Medical management with medications and neuromodulators forms the mainstay of treatment.
Nerve Blocks, Radiofrequency (RF) procedures and intrathecal delivery of opioids through implanted pumps are often done for severe pain.
However, all of these only address the neuropathic aspect of the pain, and treat only the symptoms, which are often in themselves refractory to the above treatments.
Patients often find that pain relief is incomplete/short-lived/ recurring, and often continue to have a low quality of life.

Our Alternative Approach and Outcomes

At Ashirvad, we believe that visceral pains are reflected in the muscles of the trunk, in the abdomen and back. In case of pelvic pains, the muscles of lower abdomen buttocks, inner thighs and perineal muscles are involved. While conventional treatments only address the neuropathic aspect of the pain, we use a multimodality treatment that first addresses the neuropathic aspect of pain, followed by the neuromuscular component that drives the pain and causes disability.

First, the neuropathic aspect is addressed with medications (pain killers and neuromodulators), nerve blocks of the celiac plexus, hypogastric plexus, ganglion impar etc and RF procedures for the same structures.
Instead of the regular RF, we apply a combination of pulsed RF of nerves where the nerves are not destroyed, but their vitality is retained.
In chronic pelvic pains, we also use continuous caudal block to produce a switch-off of pain to provide a pain holiday for the patient, so that the spinal sensitization that maintains most chronic pains is interrupted.

Once significant pain relief is attained, a treatment called ultrasound-guided dry needling is employed to tackle the unaddressed muscle pathology in abdominal and visceral pains. This is a magic bullet for many chronic pains in this area and relieves the pains significantly, reliably and with predictable accuracy. Other treatments that also help with muscle pathology in these pains include trigger injections performed with ultrasound guidance into the nerves and muscles of abdomen and pevis, and botox injections into muscles of abdomen, pelvis, and perineum.

This combinatorial approach provides complete or close to complete, long-lasting pain and disability relief, and our patients are often able to attain the lifestyle previously enjoyed before the onset of their pain condition.

Pelvic Pain Management

What is Pelvic Pain?

Causes Of Abdominal & Pelvic Pain :

Current Management and Outcomes:

Our Alternative Approach and Outcomes

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