Find Relief From Chronic Pelvic Pain

Experience relief from chronic pelvic pain - JOGO's expert physicians specialise in treating various gynaecological conditions.

Book an Appointment

Understanding Chronic Pelvic Pain

Chronic pelvic pain (CPP) is typically characterised as non-malignant pain that occurs intermittently or continuously in the pelvis, intrapelvic structures, or lower abdomen. The condition is classified as chronic if it lasts at least three to six months or sooner if non-acute and central sensitisation pain mechanisms are involved.

In women, CPP is not solely linked to sexual activity, pregnancy, or menstrual cycles, and it is often severe enough to impair daily function and necessitate medical intervention.

CPP is more prevalent in women than in men and commonly affects individuals aged 36 to 50. Identifying the precise cause of the pain can be challenging, complicating efforts to understand its epidemiology and prevalence. However, it is estimated that about 25% of women of reproductive age experience CPP.

Causes of Chronic Pelvic Pain

Chronic pelvic pain (CPP) can arise from various conditions, not all of which are related to reproductive health. Issues with the bowel or urinary tract can also contribute to this discomfort.

It is not uncommon to identify multiple potential causes for CPP, and in some cases, no definitive cause can be found. However, the absence of a diagnosable cause does not invalidate the reality of the pain. Experts acknowledge that pinpointing an exact cause for pelvic pain can often be challenging. Common sources of CPP include:

Pelvic Inflammatory Disease (PID)

An infection of the reproductive organs, PID, can cause both acute and chronic pelvic pain. Symptoms might include fever, lower pelvic pain, and abnormal vaginal discharge, although many cases are asymptomatic.

Dysmenorrhea (Painful Periods)

While mild pain during menstruation is expected, some women experience severe pain that can last one or two days each month. This may be due to high levels of prostaglandins produced by the uterus lining during menstrual cycles.

Endometriosis

This condition is suspected when menstrual pain intensifies over time, persists beyond the initial days of the menstrual flow, occurs throughout the month, or is present during sexual intercourse.

Musculoskeletal Issues

Chronic pelvic pain can also stem from conditions affecting joints, bones, and connective tissues, such as pelvic floor muscle tension, fibromyalgia, hernias, or inflammation of the pubic joint.

Fibroids

These growths on or within the uterus can cause increased menstrual bleeding and frequency and are often accompanied by abdominal or lower back pain.

Digestive System Disorders

Conditions like inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), gastrointestinal cancers, or diverticulitis are known to cause pelvic pain.

Urinary Tract Issues

Chronic pelvic pain may be linked to various urinary conditions, including recurrent urinary tract infections, kidney stones, bladder cancer, or interstitial cystitis—a chronic inflammation of the bladder lining and wall characterised by frequent urination, urgency, and pelvic pain.

Mental Health Factors

Psychological stressors such as chronic stress, depression, and histories of physical or sexual abuse can increase the risk of CPP. Emotional distress can exacerbate pain, which, in turn, can worsen mental distress, creating a cycle that prolongs both symptoms.

Musculoskeletal issues are a significant contributor to chronic pelvic pain:

Conditions such as disk injuries and lower back pain can lead to ongoing pelvic discomfort.
Spasms in the pelvic muscles are another common source of chronic pelvic pain.
Being overweight can exert additional strain on muscles and joints, including those in the pelvic area, contributing to discomfort.
During and shortly after pregnancy, the ligaments in the spine and pelvis can be stretched or stressed, potentially leading to what is known as peripartum pelvic pain syndrome.
Poor posture may also play a role in aggravating pelvic pain.
Myofascial pain syndrome, a condition involving tender spots within the muscle known as trigger points, can cause pain in adjacent areas of the body.

Get Pelvic Pain Relief

JOGO's integrated approach to pain management offers a new horizon for reclaiming comfort and mobility. Book your appointment now.

Book an Appointment

Complications Caused by Chronic Pelvic Pain

Chronic pelvic pain (CPP) poses several challenges that can impact both physical and emotional well-being:

Persistent Pain

CPP often lasts for extended periods, with varying intensity, that may increase during activities such as menstruation, physical exertion, or intercourse.

Mental Health Impact

The continuous presence of CPP can profoundly affect mental health, potentially leading to anxiety, increased stress, and depression. This ongoing distress can worsen the pain, creating a cyclical effect where psychological issues amplify the sensation of pain.

Sexual Dysfunction

Individuals with CPP may encounter difficulty performing sexual activities, which can result in painful intercourse, strain on relationships, and reduced libido.

Physical Limitations

CPP can restrict one’s ability to engage in physical activities, impacting daily functions and, in severe cases, leading to disability.

Underlying Complications

CPP may be linked to conditions like pelvic inflammatory disease (PID), interstitial cystitis, and endometriosis, which can cause further health issues such as infertility if not adequately addressed.

Gastrointestinal Distress

Often accompanying CPP are gastrointestinal conditions such as irritable bowel syndrome (IBS), which can intensify symptoms, including diarrhoea, constipation, and bloating.

Treatment for Chronic Pelvic Pain

For the effective management of chronic pelvic pain (CPP), we incorporate a comprehensive biopsychosocial model. We follow a multidisciplinary approach to improve symptoms and enhance quality of life. There is growing evidence that pelvic floor muscle dysfunction is a significant contributor to CPP. Hence, pelvic floor rehabilitation forms a crucial component of treatment, involving various therapeutic interventions:

A manual therapy for the muscles of the pelvic floor.
EMG biofeedback and Kegel perineometers
Techniques such as Electro-Acupuncture and Percutaneous Tibial Nerve Stimulation are employed for electrical stimulation.
Myofascial Release addresses painful trigger points through both internal methods, such as Thiele massage techniques, and external methods.
Relaxation Techniques
Specific exercises to strengthen the pelvic floor muscles and stabilise core muscles.
Stretches for the pelvic floor muscles, adductors, and iliopsoas
Correction of posture
Kegel Exercises are recommended for both females and males, particularly effective in cases of CPP with symptoms of urinary incontinence, often combined with other physiotherapy treatments.
Pain management and cognitive coping strategies, including education on psychological factors such as pain-related fear, anxiety, and exaggerated negative thinking. All these can impact sexual function and the perception of pain during activities like intercourse.

JOGO’s Treatment Plan for Chronic Pelvic Pain

JOGO Therapy uses state-of-the-art, noninvasive Digital EMG biofeedback technology. At JOGO, we treat Chronic Pelvic Pain with Digital Therapeutics (DTx) assisted Pelvic Floor Muscle Training (PFMT). JOGO treatment does not have any side effects or complications. It is created with clinically-proven EMG Biofeedback, which has been researched for many years to treat the condition in men and women. The biofeedback device measures the strength of muscles and the muscle tone using either external electrodes or vaginal or rectal probes. This cutting-edge therapy employs advanced sensors to detect muscle activity, which patients can monitor in real time via graphical displays on a tablet or computer. A screen displays when and how your muscles contract or relax. The feedback can be used for therapeutic training and to measure your progress. Specialists meticulously tailor each treatment plan to meet each client's specific requirements.

Book an Appointment

Conduct Initial Assessment

Set a Therapy Goal for the Individual Patient

Complete the Treatment

Get Discharged

You can choose from direct or online sessions provided by JOGO's Digital Clinic through certified pelvic floor therapists. Patients also receive a JOGO kit that's shipped home for teletherapy.

Frequently Asked Questions

How does counselling assist in managing chronic pelvic pain?

Counselling, particularly cognitive behavioural therapy (CBT), plays a vital role in managing chronic pelvic pain. It may also include sex therapy, which helps in reducing pain during intercourse, enhancing sexual pleasure, and alleviating general pelvic discomfort. The recommendation for counselling does not imply that the pain is purely psychological. Rather, it is an integral part of a comprehensive treatment approach.

Where is pelvic pain typically located in females?

Pelvic pain is generally felt in the lower abdominal area, extending above the legs. The pelvis is a crucial region housing several vital organs, such as the bladder, bowel, uterus, fallopian tubes, and ovaries. Pain in this area can stem from various causes.

What are the common symptoms of chronic pelvic pain?

Chronic pelvic pain can manifest in various forms, and symptoms can differ significantly among women. Common symptoms include:

Persistent, severe pelvic pain
Sharp or cramping sensations
Intermittent pain episodes
Feelings of pressure in the pelvic region
Dull, aching discomfort

Many affected individuals may experience disruptions to their daily lives, including missed workdays, challenges with non-strenuous activities, and difficulty sleeping. The intensity of pain varies widely, ranging from mild to debilitating.

How do you diagnose chronic pelvic pain?

Diagnosing chronic pelvic pain begins with a detailed consultation where your doctor will review your symptoms and medical history, followed by a comprehensive physical examination. The focus will be on determining the severity and onset of the pain. Your doctor will assess pain and sensitivity by feeling your abdomen and the pelvic structures, including organs, tissues, and muscles. A pelvic exam is also conducted to evaluate the cervix, vagina, vulva, uterus, and ovaries.

Based on the examination and your symptoms, your doctor may recommend additional tests to pinpoint the affected organs, detect possible infections, and further investigate your condition. These tests might include:

Laboratory tests
Laparoscopy
Pelvic ultrasound
Pelvic MRI
Colonoscopy
Cystoscopy

View References

Chronic pelvic pain in women - Symptoms and causes [Internet]. Mayo Clinic. 2019. Available from: https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/symptoms-causes/syc-20354368
Chronic pelvic pain in women - Diagnosis and treatment - Mayo Clinic [Internet]. www.mayoclinic.org. Available from: https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/diagnosis-treatment/drc-20354371
https://www.facebook.com/WebMD. Causes and Symptoms of Chronic Pelvic Pain [Internet]. WebMD. WebMD; 2008 [cited 2024 Sep 14]. Available from: https://www.webmd.com/women/causes-symptoms-chronic-pelvic-pain
Chronic Pelvic Pain [Internet]. www.acog.org. Available from: https://www.acog.org/womens-health/faqs/chronic-pelvic-pain
Chronic Pelvic Pain in Women [Internet]. Yale Medicine. Available from: https://www.yalemedicine.org/conditions/chronic-pelvic-pain
Chronic Pelvic Pain [Internet]. Physiopedia. Available from: https://www.physio-pedia.com/Chronic_Pelvic_Pain
Arnold MJ, Osgood AT, Aust A. Chronic Pelvic Pain in Women: ACOG Updates Recommendations. American Family Physician [Internet]. 2021 Feb 1;103(3):186–8. Available from: https://www.aafp.org/pubs/afp/issues/2021/0201/p186.html

Experience Holistic Pain Relief

JOGO offers a team-driven, holistic approach to managing your chronic pelvic pain. Connect with our specialists today and start your journey toward a pain-free life.

Book an Appointment

Chronic Pelvic Pain

Understanding Chronic Pelvic Pain

Causes of Chronic Pelvic Pain

Get Pelvic Pain Relief

Complications Caused by Chronic Pelvic Pain

Treatment for Chronic Pelvic Pain

JOGO’s Treatment Plan for Chronic Pelvic Pain

Frequently Asked Questions

How does counselling assist in managing chronic pelvic pain?

Where is pelvic pain typically located in females?

What are the common symptoms of chronic pelvic pain?

How do you diagnose chronic pelvic pain?

Experience Holistic Pain Relief

Discover Us Across Major Cities in India

Introducing Free Consultation