Pelvic Floor Dysfunction: A Common but Overlooked Cause of Pain
“Pelvic floor dysfunction (PFD) refers to a broad constellation of symptoms & anatomic changes related to abnormal function of the pelvic floor musculature. The disordered function corresponds to either increase activity (hypertonicity) or diminished activity (hypotonicity) or inappropriate coordination of the pelvic floor muscles” [1]. This widespread & frequently neglected condition, necessitates an accurate diagnosis by a Pain Doctor, who will then provide you with a Personalised Holistic Treatment Plan
Did You Know?
The clinical characteristics of pelvic floor dysfunction can be:
• Urologic
• Gynaecological, or
• Colorectal
• Moreover, these aforementioned conditions are often interlinked [1]
Your Pain Consultant will however, explain them in layman’s terms by compartmentalising them into three different regions of the body:
• Anterior- urethra/bladder
• Middle- vagina/uterus, and
• Posterior- anus/rectum [1]
“Pelvic floor dysfunction is often associated with women’s health & post-partum recovery, but it is also quite prevalent in men. Common pelvic pain conditions include: erectile dysfunction, prostatitis, urinary incontinence, levator ani syndrome, pudendal neuralgia, & chronic pelvic pain syndrome (among many others)” [2]
So What is Behind Pelvic Floor Dysfunction?
There is a broad spectrum of conditions which Pain Doctors attribute to PFD. These comprise:
• Hypertonicity
• Hypotonicity
• Loss of pelvic support, and
• Mixed concerns [1]
Urological Issues
Such issues which can be uncovered by a Pain Doctor, incorporate: difficulty urinating, hesitancy to urinate, and urinary flow delay. As well as
cystocele, that is to say: herniation (bulging) of the bladder into the vagina (anterior). In addition to
urethrocele (urethral prolapse), namely: bulging of the urethra into the vagina (anterior). And
urinary incontinence, which refers to: involuntarily leaking urine [1].
Gynaecological Issues
Research shows that this can include:
• Dyspareunia (pain at the time of, or post-sexual intercourse
• Uterine prolapse (uterus herniation through the vagina beyond the introitus)
• Vaginal prolapse (vaginal apex herniation beyond the introitus)
• Enterocele (intestinal herniation into the vagina (apical/posterior)
• Rectocele (rectum herniation into the vagina (posterior) [1]
Colorectal Issues
These cover:
• Constipation3]
• Fecal incontinence
• Rectal prolapse [1]
Booking an Online or In-Person Appointment With a Pain Doctor
Once your Pain Consultant has reviewed your medical history, they will then ask you pertinent questions, and arrange for any necessary tests or scans. As every patient is different, you are advised to start a ‘Pain Diary,’ which has daily slots divided into 24 hours. Write as much information as possible on each entry. This will be most appreciated by your Pain Doctor. Moreover, it will be easier for you than having to explain all the recent pain incidences you have experienced.
References
[1]. Grimes WR, Stratton M. Pelvic Floor Dysfunction. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
https://www.ncbi.nlm.nih.gov/books/NBK559246/
[2]. Tavel, G. (2020). “What to Do About Pelvic Pain.” Men’s Health
https://www.menshealth.com/fitness/a32404020/pelvic-floor-dysfunction/