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Recognizing and treating pelvic pain and pelvic floor dysfunction.

Heidi Prather1, Theresa Monaco Spitznagle, Sheila A Dugan

  • 1Section, Physical Medicine and Rehabilitation, Washington University Orthopedics, One Barnes Jewish Hospital Plaza, Suite 11300, Saint Louis, MO 63110, USA. pratherh@wudosis.wustl.edu

Physical Medicine and Rehabilitation Clinics of North America
|August 7, 2007
PubMed
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Pelvic floor pain affects many women but is often missed. Physiatrists can help diagnose and treat this condition, improving function and quality of life.

Area of Science:

  • Physical Medicine and Rehabilitation
  • Women's Health
  • Pain Management

Background:

  • Pelvic pain affects 3.8%–24% of women aged 15–73.
  • Pelvic floor pain and dysfunction are frequently overlooked in clinical practice.
  • Physiatrists possess unique expertise in musculoskeletal and nervous system disorders relevant to pelvic pain.

Purpose of the Study:

  • To highlight the prevalence and impact of pelvic floor pain and dysfunction in women.
  • To emphasize the crucial role of physiatrists in managing these conditions.
  • To provide an overview of pelvic floor anatomy, neurophysiology, function, and related pain syndromes.

Main Methods:

  • Review of current literature on pelvic pain and dysfunction.
  • Discussion of diagnostic considerations, including key patient history questions.

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  • Outline of treatment strategies for pelvic floor dysfunction.

    • Main Results:

    • Pelvic floor dysfunction can significantly impair bowel and bladder function, intimacy, and social engagement.
    • Specific questioning regarding urinary/fecal incontinence, dyspareunia, and pain with activities is essential for diagnosis.
    • Early identification and management are critical to prevent long-term functional deficits.

    Conclusions:

    • Physiatrists are well-positioned to manage women with pelvic pain due to their comprehensive understanding of pain, physiology, and function.
    • Effective management requires a thorough understanding of pelvic floor anatomy and neurophysiology.
    • Addressing pelvic floor dysfunction can restore function and improve patients' overall quality of life.