骨盆 疼痛

原因

Chronic pelvic pain has many possible causes and may involve different systems in the body, 包括泌尿系统, 生殖胃肠, 肌肉骨骼和神经系统. 症状可能因病因而异. When we explore all the potential sources and address the issues we uncover, many women find relief.

妇科原因

子宫内膜异位

子宫内膜异位 is a condition in which the lining of the uterus (endometrium) grows outside the uterus. The lining can attach to the ovaries, fallopian tubes, intestines or other structures in the pelvis. Adenomyosis occurs when tissue from the lining of the uterus grows in the muscle of the uterus.

子宫内膜异位症可能引起盆腔疼痛，尤其是在月经期间. 荷尔蒙 月经周期 导致子宫内膜异位症每月出血. This can be painful and result in the formation of pelvic adhesions, also known as scar tissue. 被困在卵巢中的血液会形成囊肿. 这叫做子宫内膜异位瘤.

盆腔粘连

粘连是将器官连接在一起的疤痕组织带. 它们是由以前的感染造成的, 如阑尾炎或盆腔炎, 通过骨盆或腹部手术, 或者子宫内膜异位症. 粘连很难诊断, but in some cases the uterus and ovaries feel bound together on pelvic examination. A definitive diagnosis of adhesions is usually made during surgical exploration, 经常通过腹腔镜检查.

Symptoms from adhesions include generalized pelvic discomfort or localized pain. 手术切除疤痕组织可以减轻疼痛. 然而，有时粘连会重新形成.

外阴疼痛

外阴疼痛 is pain at the opening to the vagina or the surrounding lips (vulva). 原因尚不清楚. 人们认为神经, 该区域的肌肉和组织都发炎了, 所以治疗的重点是解决这些因素.

有这种情况的女性可能会觉得插入卫生棉条很痛苦, 性交，甚至穿紧身裤. 症状包括灼烧、刺痛、刺痛、刺激和疼痛. 疼痛可持续性或间歇性，局部或弥漫性.

Non-Gynecologic原因

非妇科疾病也会引起盆腔疼痛. 最常见的是:

肠易激综合症

肠易激综合症(IBS) 会引起腹泻、便秘，还是两者兼而有之. 胀气和不适的症状可通过排便得到缓解. 压力和饮食会加重病情. The 妇科 provider may make a referral to a gastrointestinal specialist for diagnosis and treatment.

间质性膀胱炎

间质性膀胱炎(IC)是一种疼痛的膀胱综合征. 这和其他膀胱症状, 比如尿频或尿急, 可能需要泌尿科十大赌博平台排行榜评估.

肌肉骨骼的原因

Musculoskeletal causes of pelvic pain are very common but are often overlooked. The muscles, joints and nerves in the pelvis can be injured just like any other part of your body. 例如, 组织可能被过度拉伸, torn or cut in childbirth or surgery; muscles can weaken or tighten from disuse and injury; and habitual postures and movements can slowly stretch or compress structures in the pelvis, 导致疼痛和功能障碍. The pelvic muscles, joints and nerves may be the sole cause of pain or just a piece of the problem.

慢性疼痛是由骨盆周围肌肉痉挛引起的, 又称盆底肌. 肌肉的“吊索”, 还有叫做筋膜的结缔组织, 抬起并支撑包括膀胱在内的盆腔器官, 子宫和直肠. Spasms in these muscles — known as pelvic floor tension myalgia or levator ani syndrome — may cause pain locally. 肌肉紧绷, 被称为触发点, 也许摸起来很柔软, 他们可能会将疼痛转移到骨盆的其他部位, 腹部和下背部.

A thorough examination of the 腹部和骨盆 can uncover these sources of pain, 哪些可以用物理疗法和生物反馈来治疗.

抑郁和焦虑

Many women with chronic pain suffer from anxiety, depression, or both, which worsens pain. 反复发作或慢性疼痛会使一些女性感到抑郁. 这些感觉是正常的. 在其他情况下，盆腔疼痛可能是抑郁或焦虑的症状. It's essential to address depression or anxiety with therapy and medications as needed.

诊断

The diagnosis of chronic pelvic pain requires a good patient history and physical exam. 按你的约定, 请准备好来讨论你健康的方方面面, 包括你过去的病史, 痛苦的历史, 性史和精神健康.

The physical exam will thoroughly assess the many possible sources of pelvic pain discussed under "Symptoms,“尤其要注意肌肉骨骼系统，包括背部, 腹部和骨盆. 棉签测试可以用来测试阴道外和附近的神经.

If needed, we may order other diagnostic tests such as blood work, urine tests, a pelvic 超声波 或laproscopy. 如果你有膀胱症状，你可能会被转介给泌尿妇科十大赌博平台排行榜, 如果你有胃肠道症状，也可以去看肠胃科十大赌博平台排行榜. 如果你的慢性盆腔疼痛与肌肉骨骼有关, 我们可能会把你推荐给物理治疗师进行进一步的评估和治疗.

治疗

慢性盆腔疼痛的治疗是因人而异的, 这取决于疼痛的潜在原因. 一些治疗方案包括:

• 用于子宫内膜异位症或大量月经出血的激素.
• 疼痛 medications such as narcotics, nonsteroidal anti-inflammatories or medicines for nerve pain.
• 手术治疗一些粘连、子宫腺肌症或子宫内膜异位症的妇女.
• Physical therapy and biofeedback for women with myofascial (connective tissue) or muscle pain.
• 心理治疗，药物治疗，或者两者都可以帮助你应对慢性疼痛. 治疗师可以提供支持和工具来处理慢性疼痛, and can also help you and your partner cope with the relationship and sexual issues that can arise as a result of chronic pain.
• 身心技巧，如冥想、呼吸法、引导意象和瑜伽.
• Nutrition and supplements — for instance, a diet rich in fruits, vegetables and grains is important. Avoiding foods that can increase inflammation and increasing foods that decrease inflammation can be useful.
• 替代治疗系统，如传统中医, 哪些被发现有助于缓解疼痛. 我们可以把你介绍给合适的十大赌博平台排行榜.

慢性疼痛是很难处理的. It's important to set reasonable goals and develop a treatment plan that addresses your unique health needs. 注意自己的情绪健康也很重要, 专注于给你的生活带来快乐和意义的事情.

物理治疗

Some studies show physical therapy helps 60 percent of women with chronic pelvic pain and levator ani syndrome. 它有助于调整骨骼或肌肉的不平衡, 减少异常的肌肉紧张和软组织, 加强你的核心肌肉，防止进一步的伤害. A physical therapist can also help identify other factors that may contribute to your pain, 比如姿势不好, 定位与习惯.

访问期间, 你的理疗师会给你做一个全面的肌肉骨骼检查, 确定疼痛和功能障碍的来源. 有时是脚的排列, 臀部, 背部会影响骨盆的姿势，使疼痛循环持续下去. A woman who has had chronic pelvic pain long-term may notice she has symptoms in other areas of her body. 病人 may notice changes in the muscles, skin and tissue of the pelvis, back and abdomen.

Your physical therapist will examine the muscles of the pelvic floor as well as the abdomen, 大腿和背部. The therapist will work with you to develop a treatment plan to address your specific issues and goals.

Physical therapy techniques for disorders of the joints and soft tissues of the pelvis may include education, 内外肌筋膜松解, 手动疗法, 治疗性运动, 以及电刺激或生物反馈等治疗方法. 你也可以在家里使用工具进行自我治疗, 比如扩张器和一种叫做水晶棒的产品. 家庭项目也是物理治疗的重要组成部分, 维持和改善我们在诊所所做的肌肉骨骼变化.