How Is Pelvic Pain Diagnosed?

There are numerous causes of chronic pelvic pain. Sometimes the cause of your pain syndrome is fairly obvious based upon history and clinical examination. In these cases, you may not require additional diagnostic tests. If your problem is not so straightforward, such tests may be required.

Blood and urine tests may be used to screen for hormonal imbalances that can be present in some pelvic pain conditions. Cultures obtained either from blood or taken during pelvic examination may reveal infections that can cause chronic pelvic pain.

CT and MRI scans are useful for identifying structural problems in the lumbosacral spine and pelvis that may be causing your pain. Ultrasonography is another very effective way to evaluate cysts, tumors, and other masses in the abdominal and pelvic regions.

The most important diagnostic study in the evaluation of peripheral nerve problems is electromyography (EMG) with nerve conduction studies (NCS). This study provides accurate, quantitative information on the function of nerves and muscles. Sometimes it is the only way to reliably localize a lesion, quite crucial if surgery is being contemplated. Unfortunately, this study can make some patients uncomfortable, as it involves placement of tiny needles into the muscles. Most patients, however, tolerate the procedure just fine.

Urodynamic studies may be performed to evaluate bladder function. Abnormalities of the bladder, generally identified during these studies, are fairly common causes of chronic pelvic pain.

An evaluation by a pelvic floor physical therapist may reveal a myofascial cause for your pelvic pain. Generally, this occurs when muscles and ligaments of the pelvic floor fail to relax, and cause pain similar to muscles in the arms or legs that become sore following strenuous use.