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Pain and Pelvic Heaviness


WHAT IS PELVIC PAIN?

Although the answer to this question may seem obvious, this common condition presents very differently. It may have varied underlying causes and can be difficult to treat. It is often seen in association with other problems such as obstructed defecation, which might give some clues to its cause and optimal treatment.

WHAT ARE THE CAUSES?

There are many causes of pain. For some there may be a problem such as an anal fissure or abscess with relatively straightforward (surgical) solutions. For others, the pain may be very occasional and severe but without any obvious underlying cause. For the remainder, there may be a definite but less obvious explanation, ranging from prolapse to a trapped nerve.

WHAT IS THE TYPICAL PAIN THAT A PATIENT EXPERIENCES?

There is often no typical type of pain, but there may be certain characteristics of the pain that point towards one particular cause, such as:

  • Pelvic heaviness especially on prolonged standing and sometimes combined with lower back or abdominal pain might be a sign of bowel prolapse.
  • Pain worsening on sitting and relieved by standing, can be typical for pudendal nerve entrapment.
  • A very severe spasm-like pain in the anal/perineal area lasting up to 20 minutes, often at night or after opening the bowel. This is known as ‘proctalgia fugax’.

WHAT ARE THE TREATMENTS?

Given that this is such a complex area, it is difficult to generalize with regard to the best treatment. This is likely to involve a number of specialists and techniques. It may involve chronic pain specialists, surgical interventions, nerve blocks and physiotherapy.

Sometimes surgery can be helpful, particularly in defined problems such as abscesses, fistulae, pudendal nerve entrapment, endometriosis or high-grade prolapse.

Symptoms of proctalgia fugax should be assessed by your doctor. This condition is not normally treated, but if you suffer repeatedly there may be treatment options.

WHAT ARE THE CHANCES OF SUCCESS?

Pelvic pain, in common with other chronic pain conditions, is a challenge to treat. It is possible to achieve long-term cure in some patients, whilst in others partial relief is all that can be managed. There are refractory cases in which expert pain management within a specialist clinic is the mainstay of treatment.

We can advise on the best course of action based on your symptoms and test results.


Please be advised that the information on this website is not a substitute for professional medical advice, diagnosis or treatment