Common Pelvic Pain Causes

Mr. Mohanty Explains Common Pelvic Pain Causes

Pelvic pain can be a persistent and life-disrupting condition affecting both men and women. While often associated with gynecological issues in women, pelvic pain can arise from various underlying conditions involving the bones, muscles, joints, urinary system, digestive organs, and reproductive system. Mr. Mohanty, a highly experienced orthopedic and pelvic health specialist, offers valuable insights into the common causes of pelvic pain, how they manifest, and what patients can do about them.

What Is Pelvic Pain?

Pelvic pain refers to discomfort that occurs in the lower part of the abdomen and pelvis — the area below the belly button and between the hips. The pain may be dull, sharp, intermittent, or constant. It may also be associated with other symptoms like urinary difficulties, bowel problems, or sexual dysfunction.

According to Mr. Mohanty, accurately identifying the source of pelvic pain is critical for effective treatment. The causes can range from musculoskeletal conditions to inflammatory diseases, nerve entrapment, or organ-related issues.

1. Musculoskeletal Pelvic Pain

Many people don't realize that muscles, joints, ligaments, and bones in the pelvic region can all contribute to pain.

Pelvic Floor Dysfunction

Mr. Mohanty explains that pelvic floor dysfunction is a common yet often overlooked cause of chronic pelvic pain. This condition occurs when the pelvic floor muscles become too tight (hypertonic) or too weak (hypotonic), leading to pain, urinary issues, or bowel discomfort.

Symptoms may include:

·         A feeling of pressure or fullness in the pelvis

·         Pain during intercourse

·         Difficulty urinating or defecating

Treatment typically involves pelvic physiotherapy, muscle retraining, and sometimes biofeedback.

Sacroiliac Joint Dysfunction

The sacroiliac (SI) joint, located where the spine meets the pelvis, is another frequent pain generator. Dysfunction in this joint can lead to lower back pain that radiates into the buttocks or groin.

Common causes include trauma, arthritis, or poor biomechanics. Management involves manual therapy, joint injections, and posture correction exercises.

2. Gynecological Causes of Pelvic Pain (Women)

Mr. Mohanty points out that many women with pelvic pain may be dealing with conditions rooted in the reproductive organs.

Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, causing inflammation and pain, especially during menstruation.

Symptoms may include:

·         Painful periods

·         Pain during sex

·         Chronic lower abdominal pain

Endometriosis often requires a multidisciplinary approach including medication, hormonal therapy, and sometimes surgery.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that can develop on the ovaries. While many are harmless, larger cysts or ruptures can lead to sudden, sharp pelvic pain.

These can be identified through ultrasound imaging, and treatment may involve monitoring, pain control, or surgical removal.

3. Urological Causes of Pelvic Pain

Mr. Khitish Mohanty emphasizes the importance of checking for urinary tract and bladder conditions, especially in cases of chronic pelvic pain with urination difficulties.

Interstitial Cystitis (Painful Bladder Syndrome)

This is a chronic bladder condition characterized by frequent urination, urgency, and pelvic discomfort, particularly as the bladder fills.

Patients often describe a burning sensation and pelvic pressure. Management includes dietary modifications, bladder training, physical therapy, and sometimes medication.

Prostatitis (Men)

In men, prostatitis—inflammation of the prostate—can be a major contributor to pelvic pain. It can be bacterial or non-bacterial and may cause:

·         Pain in the perineum or lower back

·         Difficulty urinating

·         Painful ejaculation

Treatment varies from antibiotics for infection to pelvic floor relaxation and stress management in non-bacterial cases.

4. Gastrointestinal Causes

The digestive organs located in the pelvic region can also be responsible for pain. According to Mr. Mohanty, these conditions often mimic other pelvic issues.

Irritable Bowel Syndrome (IBS)

IBS is a functional gut disorder that can cause bloating, cramping, and lower abdominal pain. Stress, diet, and hormonal fluctuations can trigger symptoms.

Effective management includes dietary changes (like low FODMAP diet), stress reduction, and medications to regulate bowel movements.

Inflammatory Bowel Disease (IBD)

IBD, including Crohn’s disease and ulcerative colitis, causes chronic inflammation of the gastrointestinal tract, resulting in significant abdominal and pelvic pain, weight loss, and diarrhea.

It requires specialized treatment involving gastroenterologists, immunosuppressants, and lifestyle changes.

5. Nerve Entrapment Syndromes

Nerves running through the pelvis can become compressed or irritated, causing neuropathic pain.

Pudendal Neuralgia

Mr. Mohanty describes pudendal neuralgia as a shooting or burning pain along the path of the pudendal nerve, which affects the genital, anal, and perineal areas.

Common causes include prolonged sitting, cycling, or trauma. Diagnosis can be tricky and may require nerve blocks, MRI scans, and EMG testing.

Treatment may involve nerve decompression, medications (like anticonvulsants), and physical therapy.

6. Post-Surgical and Scar Tissue Pain

Pelvic surgeries — including C-sections, hysterectomies, or hernia repairs — can lead to the formation of adhesions or scar tissue, which may tether internal structures and cause pain during movement or menstruation.

Mr. Mohanty advises patients to watch for pain that develops months after surgery, and seek help for manual therapy, scar mobilization, or laparoscopic intervention if necessary.

7. Psychological Contributors

Lastly, Mr. Mohanty emphasizes the mind-body connection in pelvic pain. Chronic pain often leads to or is worsened by:

·         Anxiety

·         Depression

·         Trauma history

Cognitive-behavioral therapy (CBT), mindfulness, and multi-disciplinary pain management strategies are often necessary components of long-term relief.

When Should You See a Specialist?

Pelvic pain that lasts more than a few weeks, or is severe and interfering with daily life, should not be ignored. Mr. Mohanty encourages early evaluation to avoid misdiagnosis and prolonged suffering.

Diagnostic tools include:

·         Physical examination

·         Ultrasound or MRI

·         Laparoscopy (in some gynecologic cases)

·         Urodynamic studies or nerve testing

Early diagnosis leads to better outcomes, especially when combined with personalized treatment plans.

Conclusion: A Holistic Approach Is Key

Pelvic pain is rarely the result of a single issue. Often, it’s a combination of structural, muscular, organ-based, and psychological factors. Mr. Mohanty emphasizes that collaboration between specialists—including gynecologists, urologists, physiotherapists, pain specialists, and psychologists—is essential for truly resolving chronic pelvic pain.