Carilion Women's Pelvic Pain Clinic

Pelvic Pain Questions and Answers

What are typical causes of pelvic pain?

Pelvic pain is a surprisingly common problem with many potential etiologies. A wide variety of causes may lead to pelvic pain including gynecologic, genitourinary, gastrointestinal, musculoskeletal, neurologic and autoimmune issues, among others. Chronic pain often leads to an erosion of overall mental well-being and health, which can unfortunately further exacerbate painful symptoms.  

What symptoms are typically associated with pelvic pain?

The presentation of pelvic pain is largely dependent upon its origin and etiology. The pain may be sharp or dull, intermittent or constant. It may radiate around to the back or down the legs. Certain sources are associated with patterns of pain prior to and during menses. Other painful stimuli are independent of a gynecologic source, though they may present with "downstream symptoms" leading to pain with movement, intercourse or other daily activities. 

Does the clinic only see chronic pelvic pain?

The chronic pelvic pain clinic is dedicated to the treatment of pelvic pain, regardless of the time and duration that it has been present. Typically, "chronic" is a phrase associated with pain that has persisted for greater than six months. Treating pain sooner is highly encouraged. While improvement level varies and is often possible in patients after long-time duration, it is well known that early treatment and intervention yields better long-term outcomes. 

Are there risk factors for pelvic pain?

There are a variety of individual and familial risk factors for pelvic pain, including structural lesions of the gynecologic organs such as fibroids, endometriosis, adenomyosis, and certain types of ovarian cysts. There are inflammatory and autoimmune conditions of the bowel (Crohn's disease, ulcerative colitis, diverticulitis), stomach (gastritis, GERD) and gallbladder (cholecystitis). There are also a variety of general autoimmune conditions and musculoskeletal conditions associated with pain. 

When should a patient seek help for pelvic pain?

If patients have persistent pain despite treatment with their primary care physician and primary OB/GYN, and in those who have failed to respond or tolerate standard medical treatments with hormonal treatment or pain medication, pelvic pain clinic referral is warranted.

How is pelvic pain typically diagnosed?

We take an individualized, patient-directed approach to the diagnosis and treatment strategies for chronic pelvic pain. This includes a thorough history and completion of a pelvic pain questionnaire, a directed pelvic pain exam, and as needed, the assistance of imaging studies. Treatment recommendations are based upon the entirety of information and evidence to provide directed treatment. 

How is this different than seeing your "usual" gynecologist?

Our pelvic pain physicians are OB/GYNs who have undergone additional, dedicated training and focus in the treatment of chronic pelvic pain. They are passionate about patient care and the improvement of these symptoms, which can often significantly impact one's health and quality of life. 

Treatment may involve medical therapies for pain treatment, surgical treatments, often through minimally invasive techniques, and local injections and blocks. We also work closely with our colleagues, including those in pelvic physical therapy and mental health support services, and other specialists, including those in urogynecology, gastroenterology and anesthesia. Our goal is to provide comprehensive pelvic pain treatment individualized to each patient herself. 

PLEASE NOTE:  This clinic does not provide long-term prescription narcotic medications.