骨盆 疼痛

原因

慢性盆腔疼痛有许多可能的原因，可能涉及身体的不同系统, 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. 当我们探索所有潜在的来源并解决我们发现的问题时，许多女性都松了一口气.

妇科原因

子宫内膜异位

子宫内膜异位 子宫内膜(子宫内膜)生长在子宫外的一种情况. 衬里可以附着在卵巢、输卵管、肠或骨盆的其他结构上. 子宫内膜组织在子宫肌肉中生长时发生子宫腺肌病.

子宫内膜异位 may cause pelvic pain, especially during menstruation. 荷尔蒙 月经周期 cause the endometriosis to bleed each month. 这可能是痛苦的，并导致形成盆腔粘连，也被称为疤痕组织. Blood trapped in the ovary can build up into a cyst. 这叫做子宫内膜异位瘤.

盆腔粘连

Adhesions are bands of scar tissue that bind organs together. 它们是由以前的感染造成的, such as appendicitis or pelvic inflammatory disease, 通过骨盆或腹部手术, 或者子宫内膜异位症. 粘连很难诊断, 但在某些情况下，子宫和卵巢在盆腔检查时感觉捆绑在一起. 粘连的明确诊断通常是在手术探查时做出的, 经常通过腹腔镜检查.

粘连的症状包括全身盆腔不适或局部疼痛. Surgery to cut bands of scar tissue can relieve pain. 然而，有时粘连会重新形成.

外阴疼痛

外阴痛是指阴道开口或周围嘴唇(外阴)的疼痛。. 原因尚不清楚. 人们认为神经, muscles and tissues in the area are inflamed, so treatment is focused on addressing these factors.

Women with this condition may find it painful to insert a tampon, have sexual intercourse or even wear tight pants. Symptoms include burning, stinging, stabbing, irritation and rawness. The pain may be constant or intermittent, localized or diffuse.

Non-Gynecologic原因

Non-gynecologic problems can also cause pelvic pain. 最常见的是:

肠易激综合症

肠易激综合症(IBS) can cause diarrhea, constipation, or a combination of both. Symptoms of bloating and discomfort may be relieved by a bowel movement. Stress and diet can aggravate the condition. 妇科十大赌博平台排行榜可能会转诊给胃肠专科十大赌博平台排行榜进行诊断和治疗.

间质性膀胱炎

Interstitial cystitis (IC) is a painful bladder syndrome. 这和其他膀胱症状, such as the need to urinate frequently or urgently, 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. 骨盆的肌肉、关节和神经会像你身体的其他部位一样受伤. 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. 骨盆肌肉、关节和神经可能是疼痛的唯一原因，也可能只是问题的一部分.

Chronic pain can be created by spasms of the muscles that line the pelvis, 又称盆底肌. 肌肉的“吊索”, along with connective tissue called fascia, lift and support the pelvic organs including the bladder, 子宫和直肠. 这些肌肉的痉挛——被称为盆底紧张性肌痛或提肛肌综合征——可能会引起局部疼痛. 肌肉紧绷, 被称为触发点, 也许摸起来很柔软, and they may refer pain to other areas of the pelvis, 腹部和下背部.

对腹部和骨盆的彻底检查可以发现这些疼痛的来源, which can be treated with physical therapy and biofeedback.

抑郁和焦虑

许多患有慢性疼痛的女性患有焦虑、抑郁或两者兼而有之，这加剧了疼痛. Recurring or chronic pain can cause some women to feel depressed. 这些感觉是正常的. In other cases, pelvic pain can be a symptom of depression or anxiety. 根据需要通过治疗和药物治疗来解决抑郁或焦虑是至关重要的.

诊断

诊断慢性盆腔疼痛需要良好的病史和体格检查. 按你的约定, please come prepared to discuss many aspects of your health, 包括你过去的病史, 痛苦的历史, 性史和精神健康.

体格检查将全面评估盆腔疼痛的多种可能原因，详见“症状”," with particular attention to the musculoskeletal system including the back, 腹部和骨盆. A Q-tip test may be performed to test the nerves outside and near the vagina.

如果需要，我们可能会要求进行其他诊断检查，如血液检查、尿液检查、盆腔检查 超声波 或laproscopy. You may be referred to a urogynecologist if you have bladder symptoms, or a gastroenterologist if you have gastrointestinal symptoms. If you have a musculoskeletal component to your chronic pelvic pain, we may refer you to a physical therapist for further evaluation and treatment.

治疗

Treatment for chronic pelvic pain is tailored to each patient, depending on the underlying causes of the pain. 一些治疗方案包括:

• Hormones for conditions such as endometriosis or heavy menstrual bleeding.
• 止痛药物，如麻醉剂、非甾体类消炎药或神经痛药物.
• Surgery for some women with adhesions, adenomyosis or endometriosis.
• 肌筋膜(结缔组织)或肌肉疼痛妇女的物理治疗和生物反馈.
• Psychological therapy, medication, or both to help you cope with chronic pain. A therapist can offer support and tools to handle living with chronic pain, 还可以帮助你和你的伴侣处理由慢性疼痛引起的关系和性问题.
• Mind/body techniques such as meditation, breathwork, guided imagery and yoga.
• 营养和补充——例如，富含水果、蔬菜和谷物的饮食很重要. 避免吃会增加炎症的食物，多吃能减少炎症的食物是有用的.
• Alternative healing systems such as traditional Chinese medicine, which have been found to help relieve pain. We can refer you to an appropriate provider.

Chronic pain is very difficult to deal with. 重要的是要设定合理的目标，制定一个治疗计划，以满足你独特的健康需求. It's also important to attend to your emotional health, and to focus on what brings joy and meaning to your life.

物理治疗

一些研究表明，物理疗法对60%患有慢性盆腔疼痛和提肛综合症的女性有帮助. It helps to align bone or muscular imbalances, decrease abnormal muscle tension and soft tissue, and strengthen your core muscles to prevent further injury. 物理治疗师还可以帮助确定可能导致疼痛的其他因素, 比如姿势不好, 定位与习惯.

访问期间, your physical therapist will conduct a thorough musculoskeletal examination, identifying sources of pain and dysfunction. 有时是脚的排列, 臀部, and back will affect the posture of the pelvis and perpetuate the pain cycle. 长期患有慢性盆腔疼痛的女性可能会注意到她身体的其他部位也有症状. 患者可能会注意到骨盆、背部和腹部的肌肉、皮肤和组织的变化.

你的理疗师会检查骨盆底和腹部的肌肉, 大腿和背部. 治疗师将与你一起制定治疗计划，以解决你的具体问题和目标.

关节和骨盆软组织紊乱的物理治疗技术可能包括教育, 内外肌筋膜松解, 手动疗法, 治疗性运动, and treatments such as electrical stimulation or biofeedback. You may also use tools for self treatment at home, such as dilators and a product called Crystal Wand. A home program is also a vital component of physical therapy, maintaining and improving the musculoskeletal changes we make in the clinic.