Where does pelvic pain hurt?

Many people do not have enough understanding of the problem of pelvic pain, so in the end they find that some diseases are constantly changing and have a lot of impact on the human body. The main factors of pelvic pain include pain at the bottom of the pelvis. In addition, it is not ruled out that it is pain below or chronic pelvic pain, etc. The local pelvic pain is due to interference with the soft tissue, so it will cause pain in the bones, nerves and other skin and flesh.

Symptoms and signs

The pelvic cavity is the lowest part of the abdominal cavity. The pain caused by the pelvic organs mainly manifests in the lower abdomen, so pelvic pain is also called lower abdominal pain in clinical practice. Chronic pelvic pain (CPP) is a non-specific term that includes gynecological diseases that are easily detected by laparoscopy, such as endometriosis, pelvic inflammatory disease, pelvic adhesions, and pelvic venous congestion syndrome, as well as some hidden physical diseases (usually non-gynecological diseases) such as irritable bowel syndrome, and non-physical (psychogenic) diseases. Epidemiological surveys have shown that the incidence of spontaneous abortion in CPP patients is higher than that in the control group. On the one hand, spontaneous abortion may increase pelvic inflammation and lead to CPP. On the other hand, spontaneous abortion can easily make patients firmly believe that they have pelvic disease, which will accelerate the diagnosis of CPP.

The main symptoms of psychological pelvic pain are lower abdominal pain or back pain. The lower abdominal pain can be the entire lower abdomen, bilateral or unilateral iliac fossa, or no obvious location, often accompanied by vaginal discomfort, which is continuous or intermittent dull pain or pain; patients cannot explain what factors are related to the aggravation and relief of pain; the pain is caused or aggravated by sexual intercourse, but does not affect sexual life.

Patients have significant symptoms of depression, such as loss of appetite, fatigue, insomnia, loss of sexual desire or lack of interest in anything, or are impulsive and have poor self-control, and sometimes get directly angry at the doctor. Some patients somatize all emotions, or deny and repress them, showing indifferent contentment; or they show abnormal illness behavior. They have a body bias, are convinced that they have a disease, do not respond to the doctor's assurances, and persist in their pain symptoms. Although they seek treatment and the doctor's best efforts to treat them, they still have pain. Physical examination is often accompanied by neurotic symptoms, which give the physician the impression that the patient is exhausted, depressed or anxious, nervous, and irritable. Although the pain is unbearable, no positive physical signs are found during examination. Pelvic examination revealed no positive findings, but the pelvis was overly sensitive, with severe pain even with slight palpation.

Medication

Although the cause of chronic pelvic pain has not yet been elucidated, the current basic view is that CPP is a complex disease involving physical and mental factors. Even if there are obvious physical lesions that can cause pelvic pain, the impact of psychological and social factors on the disease cannot be ignored. Treatment requires a multidisciplinary comprehensive approach, including surgery, medication, physical therapy, psychotherapy, diet therapy, etc. The goals of treatment are to relieve pain, improve function, and eliminate psychological barriers, but treatment is less effective for patients with a long course of illness.

The general principle is to first find out as many pathogenic factors as possible. The most effective clinical approach requires treating all possible factors simultaneously: anatomical, musculoskeletal, bowel and bladder functional, psychological problems, etc. Concurrent treatment, which usually involves starting with multiple medications, is often very effective in relieving pain, but can be worrisome. Through regular, planned and close follow-up, the dosage of the drug can be gradually reduced as appropriate, and the patient's condition and needs can be understood in a timely manner.