Pelvic pain - specialists and information

Like back pain,pelvic pain is usually non-specific. It is particularly common after pregnancy. Find out here how pelvic pain occurs and how it can be diagnosed and treated.

You can also find selected specialists for the treatment of pelvic pain here.

What is pelvic pain?

Pelvic pain can occur in both men and women. In most cases, it originates from the pelvic organs or the bony pelvis.

Bruises or fractures are also triggers for pelvic pain. A blockage of the sacroiliac joint is also possible. In this case, the pain radiates into the buttocks. However, it can also be non-specific.

The nature of the pain alone often makes it unclear what the cause is. It is therefore advisable to have these symptoms investigated by a specialist.

The symptoms of pelvic pain

Patients with pelvic pain usually have pain in the lower abdominal region, below the navel.

The pain can be as follows:

• dull
• stabbing
• cramp-like

The pain is often only on one side of the body, but can also radiate to other regions, such as the

• back
• buttocks
• legs

If the pelvic pain occurs regularly over a period of more than six months, doctors speak of chronic pelvic pain.

Causes & risk factors: How does pelvic pain develop?

As unspecific as the symptoms of pelvic pain are in many cases, the triggers are just as varied. Pelvic pain can have numerous causes.

In most cases, it is caused by diseases of the bladder, prostate, uterus or rectum.

The following triggers for pelvic pain are possible:

• Chronic bowel disease
• Cystitis or other infections
• endometriosis
• Food intolerances
• allergies
• Emptying disorders of the bladder and bowel

However, it can also be neuropathic pain. This occurs when the nerves in the pelvic area are pinched. In women, a prolapse of the pelvic floor occurs relatively frequently.

Organ prolapse in the pelvis also manifests itself in lower abdominal pain. However, they can also cause a foreign body sensation in the vagina.

Pelvic pain and cramps in the lower abdomen are also not uncommon during pregnancy. Caution is advised if severe pain occurs in conjunction with bleeding. This can be an indication of an ectopic pregnancy or a miscarriage. You should therefore definitely have this clarified by a gynecologist.

Another cause of pelvic pain is pelvic ring instability or symphysis instability / symphysis loosening. With this symptom, the ligaments that hold the pelvis together in the area of the pubic symphysis are loosened.

This symptom usually affects women after childbirth, during hormonal changes or heavy physical exertion. Around ten percent of all women develop this symptom during or after pregnancy. Both pelvic pain and low back pain are normal with such pelvic ring instability. It also leads to irritation of the SI joint and a severe restriction of mobility.

Congenital misalignments should not go unmentioned as a cause of pelvic pain. A pelvic obliquity caused by legs of different lengths is also one of the most common causes of pelvic pain.

A crooked pelvis leads to incorrect posture and incorrect loading, which can cause pain @ sumaki /AdobeStock

Examination & diagnosis of pelvic pain

The diagnosis of pelvic pain is often not easy, especially as it can also be radiating back pain.

If the pain lasts longer than four weeks, you should definitely have it checked out by a specialist. After taking a medical history, they will carry out a detailed physical examination including various orthopaedic tests.

The doctor will probably carry out an ultrasound examination to look at the abdominal organs. To rule out an infection, you will often have to give a blood and urine sample.

Treatments and specialists for pelvic pain

The doctor will decide which treatment is suitable for pelvic pain on an individual basis , depending on the cause:

In the case of pelvic ring instability, for example, the primary goal is to strengthen and relieve the ligaments. Medication and massages are also frequently used to alleviate the pain. Heat and infrared applications are also used to help.

Pelvic orthoses have also proven effective in treating pelvic pain in some cases. These can be worn under clothing. It stabilizes and relieves the ligaments in the pelvis.

There are several treatment options for musculoskeletal causes. For example, shock wave therapy can be helpful for bone marrow edema. If necessary, minimally invasive surgery can also improve the symptoms.

If the cause of the pelvic pain is found in the musculoskeletal system, a physiotherapist or chiropractor can also help.

If the sacroiliac joint is blocked, targeted adjustment can help .

If, on the other hand, inflammation is the cause of the pain, doctors may prescribe antibiotics or cortisone.

The same applies to infectious diseases of the male or female reproductive organs.

Only in rare cases is pelvic pain caused by malignant diseases such as tumors. Depending on their severity, doctors treat these with surgery, radiotherapy or chemotherapy.

A pelvic orthosis helps to relieve pain by stabilizing the pelvis @ PhotographyByMK /AdobeStock

Progression and prognosis of pelvic pain

Doctors should recognize and treat pelvic ring instability in good time. However, pelvic weakness and pelvic pain can persist for months after the birth.

In most cases, pelvic pain is not caused by serious illnesses, so the prognosis is generally very good.

In the case ofbruises, dislocations or blockages, the pain usually disappears on its own after a few days.

In the case of instability of the pelvic ring, the prognosis is also good, depending on when treatment is started. However, a doctor should make a correct diagnosis and initiate targeted therapy.

If a malignant disease is the cause, the prognosis depends on the progress of the disease. In the early stages of cancer, the prognosis is very good. However, the prognosis also depends on the patient's age and general state of health.