What is Chronic Pelvic Pain?


Have you ever had a sharp pain in your lower abdomen and all of a sudden you cannot move? Or maybe you’ve had it for a while, and it keeps you from living your life normally. If you have, you have most likely experiencing pelvic pain.

We can call it chronic pelvic pain when it lasts longer than half a year.

How do you know that it is indeed pelvic pain?

Our bodies cannot all be different and so different women will feel pelvic pain differently. Some feel a sharp pain that is there for a few minutes, and then it disappears. Some may feel it at one spot and others may feel it spread out in their abdomen.

While other women may feel it going about their days, others may only feel it when they are on their periods, during sexual intercourse or when trying to lift a heavy object. Some will even feel it while urinating. It is also not uncommon to have the pain emanating from the vulva, this kind of pain has been named vulvodynia.

What are some of the causative factors of pelvic pain?

Up to know the research jury is still out on how pelvic pain comes into being. But most of the time, it is due to problems with organs in and around your pelvic areas. Here are few health problems that may be the cause of the pain.

  • Rectal irritation – the cause for this is yet to be known, but it results in pain, constipation, bloating and even diarrhea.
  • Endometriosis – when uterial tissues start growing elsewhere, you end up with endometriosis. The two main symptoms of this condition are pain and fertility issues.
  • Pelvic floor disorders – this occurs when the tissues and muscles that make up the pelvis are weak or injured.
  • Fibroids – these are tumors (non-cancerous) that grow on the uterine walls

How is the diagnosis made?

First of all, when you realize you have chronic pelvic pain, you should visit a doctor. The doctor will then quiz you a little about your symptoms and perform a physical examination to see if there are any abnormalities. After this, they can then do any of the following tests or a few of them together.

  • Blood tests
  • Cystoscopy
  • A pelvic (MRI) scan – this enables them to see the inside of the pelvis
  • Colonoscopy
  • Pelvic laparoscopy

How can you treat pelvic pain?

The treatment options will depend on the emanating point of the pain, how often you feel it and how strong or mild it is. Any of the following may be recommended.

  • Medication – depending on your pain you may get a prescription for painkillers, muscle relaxants or anti-inflammatory drugs.
  • Lifestyle changes – for instance changing what you eat, exercising more, staying away from too much alcohol and other positive health changes may help deal with the pain.
  • Physiotherapy – the therapy helps relax muscle and tissues. It is useful when pain comes from these areas.

Final thoughts

Suffering pelvic pain can cause a strain in one’s quality of life. If you have chronic pain, it is critical that you see a doctor. A gynecologist can also help. The only problem with diagnosis is that there are a myriad of causes and each has their own type of tests. But the treatment options can help a great deal.

Research at NYDNRehab

645 ONE YEAR FOLLOW UP OF EXTRACORPOREAL SHOCK WAVE THERAPY (ESWT) FOR CHRONIC PELVIC PAIN SYNDROME (CPPS) https://www.eu-openscience.europeanurology.com/article/S1569-9056(10)60634-3/pdf
Therapeutic effects of Low intensity extracorporeal low energy shock wave therapy (LiESWT) on stress urinary incontinence https://www.nature.com/articles/s41598-020-62471-4

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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