The Treatment Map

Click to Download

Free downloadable Treatment Map

Treatment Map

Use the treatment mep to tell your story, keep track of that has been done, and to remind yourself of how much help is out there. Keep copies and bring to share with your doctors and medical staff. 

 

In the best case scenario, you and your doctor can diagnose the root of the pain right away and correct it immediately. Unfortunately, pelvic pain can be complex and require visits to more than one medical specialist.

Conditions can appear in many ways, for example: 

  • Pelvic pain from sitting (still at a desk) or moving about (when walking or running; pain in the pubic area during intimacy); sneezing

  • After eating or while going to the bathroom (e.g. constipation; bladder pain / relief with urination)

  • For females: monthly (before period, during menstruation or after period); from pregnancy -- Pelvic Girdle Pain (PGP), SPD (Symphysis Pubis Dysfunction)

Pain comes in differents degrees and forms:​​

  • Pelvic discomfort, gas pain or cramps in pelvis

  • Sore pelvis, dull ache or pelvic strain

  • Heavy feeling in pelvic area

  • Tenderness or throbbing pain

  • Burning sensation (burning pain in pelvis)

  • Constant pain in pelvis or hips

  • Sharp pains (shooting, stabbing) or other extreme pelvic pain

  • As nerve pain (such as with a herniated disc, sciatica), radiating down leg

Whether just beginning or changing course of treatment, use the first part of the Treatment Map as a pelvic pain symptom checker. You should also track progress and mark suspected issues to discuss with your doctors (which will become more beneficial as you continue learning through the book):

  • Symptoms of pelvic infection

  • Inflammation in pelvis (pelvic inflammation)

  • Feeling of a twisted or separated pelvis

  • Fractured pelvis symptoms (or broken pelvis symptoms)

  • Pubic symphysis pain (at the joint attached by cartilage)

  • Piriformis Syndrome (muscular compression of sciatic nerve)

  • Adhesions or frozen pelvis (from internal organs attaching)

Irritable bowel syndrome (IBS)

Medications can be critical for both immediate and ongoing relief. There are many, however, so it can be confusing to keep track of which you have tried and whether you experienced relief.

  • Bladder relaxants or medications to open the bladder outlet

  • Infection management (antibiotics, probiotics)

  • For males:​​ testicular / penile injections, skin applications, etc.

  • For females: vulvar / vaginal creams, ointments, suppositories, etc.

  • Hormonal medications (testosterone / estrogen)

  • Anorectal (sitz bath, barrier cream, wipes, numbing gel, stool softeners / bulking agents)

  • Immune system (Immunotherapy)

  • Anti-inflammatory (NSAIDs, steroids) and muscle relaxants

  • General pain (from acetaminophen to opioids)

  • Blood Thinners 

Testing can involve:

  • Urine analysis / urinalysis

  • X-ray

    • Upper GI Study (X-ray after swallowing dye)

    • ​Defacography (bowel movement under X-ray with dye)

    • Urethrogram (with dye in bladder or urethra)

      • Cystogram, voiding cystourethrogram (VCUG)

    • Angiogram (with dye in artery)

  • CT scan, ultrasound, MRI

  • Camera-based (-oscopy) visualizations, pressure measurements and nerve stimulation responses (EMG)

  • Cystoscopy and Urodynamic Testing

Procedures and Treatments. Additionally, there may be several helpful therapies and pain management techniques available to you:​​

  • For nerve pain: TENS (Transcutaneous electrical nerve stimulation); nerve blocks or injections

    • For males:​​ cryoablation (freezing) of spermatic cord nerves

  • For an overactive bladder -- non-invasive PTNS (Percutaneous tibial nerve stimulation) neuromodulation

  • For females: electromagnetic stimulation Emsella® Chair for urinary incontinence

    • Vaginal laser therapy

Medications
Ultrasound ovarian cyst
  • Physical Therapy (PT) - exercises​ for repairing and strengthening pelvic floor muscles

Surgery is often reserved a last resort option. In some cases surgical procedures are unavoidable. Regardless, every person and their doctor hopes for immediate relief. As with medicines, there are many possible procedure types and alternatives that you may have to consider:

  • Incontinence (loss of bladder or bowel control) and sacral nerve stimulation (Interstim®)

  • Fulgaration (radiofrequency ablation), denervation (cutting of nerves) or release of nerve entrapment

  • For males:​​ prostate (prostatitis), testis (varicocele surgery, vasectomy), ejaculatory duct, spermatic cord

  • For females: endometriosis / uterus, ovary / ovarian cyst (laparoscopy)

  • Prolapse (displaced organ in pelvis)

  • Excision / removal of abnormalities

  • Bone, muscle, blood vessel

  • Kidney stone (shock wave or telescopic, ureteroscopy)

Urologic Surgery - prostate obstruction

The recovery process can require patience.

The best chance to improve quickly is to educate yourself and your team.

We hope that our book, Facing Pelvic Pain, and its supplemental Treatment Map lead you and your team of medical professionals along the best path to overcoming pelvic pain.