Chronic Pelvic Pain

 

Chronic pelvic pain is diagnosed in both women and men. In women, it is often attributed to local gynecologic disease, interstitial cystitis, or pelvic girdle disorders, but is also caused by pain syndromes that create exaggerated bladder, bowel, or uterine pain sensitivity. In men, it is common to assign a urologic diagnosis of chronic nonbacterial prostatitis – in other words an inflammatory process affecting the male reproductive tract. Abdominal disease can masquerade as a pelvic pain syndrome – with pain emanating from the flank/kidney region, or appendix, or lower gastrointestinal tract.

At some point, as the pain syndrome progresses, it can become a central pain syndrome and might be related to abnormal spinal inhibition of pain, or be perpetuated by the mechanism of “phantom” pain. Although the pain begins in the “viscera” it can “metastasize” and “spread” into a “disseminated” pain syndrome.

Treatments include: anti-inflammatory chemicals (prescribed or herbal), extracorporeal magnetic stimulation (ExMI), or even hyperbaric oxygen therapy (HBOT). Severe cases of “central pain syndrome” which may be a form of complex regional pain syndrome (CRPS) can respond to interventional pain procedures like anesthetic blocks or spinal cord stimulation (SCS) or our “combination therapy” of ketamine co-administered with transcranial magnetic stimulation.