Should You Worry if You Have Pelvic Pain?

The first thing we must do is differentiate between two types of pelvic pain, by doing an MRI for pelvis injury, so, you should not worry if you feel some pain, and instead, you need to be sure that you get your MRI asap. See below why, as explained by a renowned physiotherapist:

1. Acute pelvic pain: This pain can be of genitourinary, gastrointestinal, or musculoskeletal origin.
2. Chronic pelvic pain: This pain can have the same origin as acute pain, but with a minimum duration of approximately 6 months.

What are your symptoms?

• Intense and constant pain.
• Pain that comes and goes (intermittent).
• Sharps or cramps.
• Pressure or heaviness in a deep area of ​​the pelvis.
• Pain during sexual intercourse.
• Pain with bowel movement or urination.
• Pain when you sit for long periods of time.

Possible causes

Within these two types of pelvic pain, we are going to differentiate those related to the reproductive system, and those not related to the reproductive system:

• Endometriosis: Occurs when cells from the lining of the womb (uterus) grow in other areas of the body.
• Tension in the pelvic floor muscles: the pelvic floor muscles can suffer contractures and spasms that cause chronic pelvic pain.
• Pelvic inflammatory disease: after suffering from a pelvic inflammatory disease (usually caused by a sexually transmitted infection) there may be adhesions or scars that affect the pelvic organs.
• Ovarian cysts: cysts can develop recurrently in the ovaries that cause pain.
• Fibroids: are benign tumors that grow from the uterine musculature. Its growth can cause a feeling of pressure or heaviness as well as pain in the lower abdomen. On rare occasions, they produce acute pain when they run out of adequate blood supply and begin to become necrotic inside (fibroid degeneration).
• Irritable bowel syndrome: the symptoms associated with irritable bowel (bloating, constipation, diarrhea…) can cause discomfort and pelvic pressure.
• Interstitial cystitis: it is a condition associated with chronic inflammation of the urinary bladder and is usually associated with the need to urinate very frequently. When the bladder fills, pelvic pain may occur, which usually improves after emptying.
• Pelvic congestion syndrome: the presence of varicose veins around the uterus and/or ovaries can result in pelvic pain.
• Psychological factors: depression, chronic stress… can generate or worsen pelvic pain.

Get a diagnosis

When it comes to chronic pain, is it difficult to reach a diagnosis? The diagnosis is usually made in a medical or gynecological consultation based on symptoms and a thorough examination of the pelvic area, which includes a gynecological examination. It can be difficult to diagnose the exact source of the pain, and tests are often needed to find the cause. These may include blood tests, scrapings or swabs from the vagina and cervix, and ultrasound scans.

When the pain becomes chronic, it is necessary to seek the opinion of a specialist, to determine its causes and possible solutions. “With any chronic pain problem, it can be hard to know when to see a doctor. In general, terms, make an appointment with your doctor if pelvic pain disturbs your daily life or if the symptoms seem to get worse”, the physiotherapist explains, adding that we should not always worry, since the pain is not always serious. “But we must never downplay any pain”, he qualifies. And he adds that relieving pain is a human right and an ethical obligation of health professionals. “You have to look for solutions and seek a quality of life, we should not assume that certain pains have to be suffered, since the vast majority have a solution,” he tells us. Of course, he points out that pelvic pain cannot be prevented in all cases. However, early treatment can reduce the chances of it establishing itself as a disease.

This is how we should treat it

The great concern of those who suffer from it is to find a treatment that alleviates it. “A multimodal and interdisciplinary approach should be considered, with various professionals from different disciplines and different perspectives and experiences motivated to help in person-centered care. The first step should always focus (whether the cause is found or not) on relieving the pain.  The frustration generated by the pain itself, the lack of sleep and the changes in life caused by the pain can make it much worse, so managing the psychological symptoms caused by the pain is highly recommended”, he tells us.

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