Pelvic pain
introduction
The human pelvis consists of the two hip bones (again each consisting of Intestines-, shame- and Ischium) and the sacrum in between. The sacrum rises above the sacroiliac joint (ISG) in connection with the two hip bones. In addition, the femoral head attaches to the hip bone in its socket.
The pelvis is anatomically divided into two sections - the large and the small pelvis. The large pelvis is the space between the two iliac blades, and the small pelvis is the area below.
However, the pelvis can also be problematic and painful for a variety of reasons. Often, pain cannot be clearly localized in this area. They can be caused on the one hand by the bony pelvis, on the other hand by the organs in the large or small pelvis. The following are possible causes of pelvic pain and how to treat them.
causes
Pelvic pain can originate from the bony pelvis.The most common cause of bone pain is traumatic events such as bruises or broken bones. Especially in the context of osteoporosis, in which the Bone density is reduced, fractures occur particularly quickly. Older people in particular are often affected by osteoporosis and therefore break bones quickly when they fall.
Read more on the topic: What kind of pain occurs with osteoporosis?
Very often, pain in the pelvic and buttocks area is a blockage of the sacroiliac joint, which is located on both sides between the hip and sacrum. Slight displacement of the bones against each other or the hooking of the stabilizing ligaments can lead to unpleasant pain in this area, which can also radiate over the entire buttocks and into the lower back.
Bad posture and congenital deformities of the skeleton are also among the most common causes of pelvic pain. A pelvic inclination, for example due to a difference in length of the legs, can lead to painful tension in the pelvic area.
Malignant diseases can also settle in the pelvic bones. These can be metastases from a tumor, but there are also cancers that develop directly in the bone, for example osteosarcoma or Ewing's sarcoma.
Soft tissue injuries to the buttocks or hips can also radiate and feel like they're coming from the bone.
On the other hand, pelvic pain can also originate from the organs located in the large or small pelvis. Diseases of the gastrointestinal tract, the female and male genital organs, the bladder or even mental tension can manifest themselves through pain in the pelvic area.
Pelvic pain can also occur during pregnancy, especially if the child grows and presses on the organs and ligament connections in the pelvic area. Contractions also trigger abdominal pain which, if it is mild, may not be recognized as such.
Pelvic pain on the right
Pelvic inclination
Right-sided pelvic pain can have different causes. For example, a pelvic inclination can lead to right-sided complaints in the pelvic area, as the body increasingly shifts weight to one side. This leads to bad posture of the entire body and uncomfortable tension.
Read a lot more information on this topic at: Pelvic inclination
Accidents
Bruises, broken bones, and other obvious injuries can also cause right-sided pelvic pain.
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ISG blockage
Another cause is a right-sided blockage of the sacroiliac joint (ISG). This is located between the iliac blade and the sacrum. It is secured by various tapes. With certain movements it can happen that the ligaments get caught and the bones shift minimally against each other and remain in this position. This ISG block is very uncomfortable and causes pain.
For more information, read also: ISG blockage
Herniated disc of the lumbar spine
It is also conceivable that right-sided pelvic pain is caused by a herniated disc of the lumbar spine, which is due to a Nerve root presses. Such pain then often radiates through the buttocks to the leg or foot.
For more information, read also: Herniated disc of the lumbar spine
Appendicitis
If the cause is not in the pelvis itself, then the organs in the pelvic area must also be considered. Particularly relevant on the right side is the appendix of the appendix, which can become inflamed (appendicitis). The pain in the right lower abdomen caused by this can be misinterpreted as pelvic pain. The inflamed appendix is removed therapeutically.
For more information, read also: Appendicitis
Diseases of the genital organs or the bladder can also lead to pain in the right side.
Severe or increasing pain that lasts for several days should therefore be clarified by a doctor.
Left pelvic pain
The most common causes of pelvic pain on the left are the same as those on the right.
Often it is pain after injuries, for example bruises or broken bones. Pelvic inclination can also cause left pelvic pain.
There is also a sacroiliac joint on the left side of the pelvis, which is located here between the left ilium and the sacrum. Here, too, the ligament apparatus can become entangled and painful tension, which can explain the symptoms. A chiropractor can target joint blocks through manipulation dissolve.
If the cause is not in the musculoskeletal system itself, an organ-related cause must be clarified. As with right-sided pelvic pain, the genital organs and the bladder are possible causes.
In addition, left-sided pain is often caused by diverticulitis, especially in older people. These are small protuberances in the lining of the colon in which stool debris can collect. This can lead to inflammation, which manifests itself in pain on the left side of the lower abdomen. Pelvic pain can also be perceived when radiating.
Longer-lasting pain or pain that increases in intensity should generally be promptly clarified by a doctor in order to rule out serious causes.
Pelvic pain after childbirth
Pelvic pain after the Birth can have various causes. One way is they not directly related to be born.
If they do this, however, they can, for example, use a Pelvic ring instability be conditional. During the birth process, the baby pushes through the mother's birth canal. The pelvis must make room and is expanded. Especially with very large children it can become a Loosening of the ligament connections come, so that the Sacroiliac joints at the back of the pool move and To block can. This can be for the woman very painful be.
In addition, the pelvis is held together at the front by a special connection - the Symphysis. This is a cartilaginous connectorthat connects the two halves of the pelvis. This connection can also be loosened during childbirth, which sometimes leads to severe pain, too radiate into the legs and back can.
Pelvic Pain During Pregnancy
In the pregnancy claims that adolescent child over time more and more space in the womb. It also practices more and more Pressure on the maternal pelvic organs out. This can cause uncomfortable pain for the woman.
especially the Stretching of the ligamentous apparatus uterus is often perceived as painful.
A common cause of pelvic pain during pregnancy is the so-called Symphysis loosening. The symphysis is one out Cartilage tissue existing connection between the pelvic bones at the front of the pelvis. As part of pregnancy the pelvic ring loosensso that the child can kick through at birth. If the pelvic ring loosens too much and gets too much leeway, however, it stretches the symphysis and calls to this one Irritation emerged. This can cause pain under certain circumstances very strong be and be through both pelvic and through move-, Hip- or Leg pain to make noticable.
Pelvic pain after exercise
Pelvic pain after exercise can through physical over- or Improper loading be conditional.
At untrained athletes can a initial overload Cause irritation of muscles and periosteum, which can cause unpleasant pain. Also sore muscles in the pelvic area can explain the pelvic pain.
Wrong footwear or one poor running technique at the Jogging can cause improper stress and a Variety of joint ailments or other pain.
Previously injured Knee joints or legs of different lengths also put additional stress on the hips and can lead to hip and pelvic pain.
If the pain persists despite a good training condition, it is advisable to do one Sports medicine or orthopedic surgeon for advice to pull. A running analysis is also a good idea to clarify whether the pain is caused by incorrect stress on the body.
Especially Beginner should the Only slowly increase the intensity of your training and do not overtax the body, so that the muscles and the rest of the musculoskeletal system only adapt to the adapt to new requirements and can get used to.
Pelvic pain when sitting
Pelvic pain that occurs when sitting is usually muscular or bone-related. One-sided pain in particular speaks for this. Bruises and broken bones in the pelvis caused by falls can cause pain when sitting, even over long periods of time. Muscular problems are particularly triggered by poor posture while sitting. The muscles tense up, which leads to tension and, as a result, pain. This in turn changes the sitting posture into a relieving posture, which results in further tension.
Misalignments of the hips, which cause problems when walking, can also act in this vicious circle and thereby worsen the tension. Muscular tension in the back of the pelvis mainly affects the back. The lumbar spine in particular is a problem area for many people. Because of the many muscles that attach to the lumbar spine and the pelvis, the pain can spread to the pelvis. When sitting, one often remains in the same position for longer, which is why pelvic pain is particularly noticeable. Many nerves also pass through the pelvis, running from the spinal cord down to the legs. These nerves can be pinched while sitting and cause pulling pelvic pain that also radiates into the legs.
Also read: Meralgia paraesthetica
Pelvic pain after a fall
The pelvis is particularly at risk if you fall at high speed (for example from a motorcycle or horseback) or if someone does not support themselves adequately with their hands. The consequences are bruises or fractures that cause pelvic pain when moving and when sitting. Since the pelvis forms the transition between the upper body and the legs, it has to carry a particularly large weight and is therefore exposed to many strong forces. These usually worsen the situation in the event of a broken pelvis after a fall.
Stabilization of the bony pelvis is therefore essential after a fall. It may be necessary to use screws on the pelvis in an operation to hold the broken parts together until they have grown back together. A pelvic fracture caused by a fall at high speed is particularly dangerous because it can lead to profuse bleeding into the pelvis. Since the pelvis is mainly made up of soft tissues, almost the entire volume of blood in the body can be accommodated in the pelvis. This is why stabilizing the pelvis after such an accident is an important measure, as it can stop the bleeding. Even slight falls, for example on the tailbone and the seat bones, cause pelvic pain over a longer period of time. However, these are mostly just harmless bruises.
Also read: Pelvic fracture
Pelvic pain in men
Pelvic pain in men is in many cases due to injuries to the pelvic bone. This can be on the ischium, which is triggered, for example, by falling on the buttocks. But the symphysis, i.e. the foremost part of the pelvis, is also predestined for bony pain. In addition, the spine flows into the pelvis, which is why a lot of back pain can be transferred to the pelvis. This includes not only bony but also muscular complaints.
Pelvic pain can also be triggered in men by the organs in the pelvis. This includes the digestive organs, such as parts of the small intestine, the transition from the small intestine to the large intestine, the cecum and the rectum. This can lead to acute inflammation (appendicitis) or abscesses. Chronic inflammatory bowel diseases such as Crohn's disease (mainly affects the transition from the small to the large intestine) or ulcerative colitis (mainly affects the rectum in the case of pelvic pain) can cause pain in the pelvic area. Diseases of the bladder and the lower urinary tract also make themselves felt as pelvic pain. There is also burning pain when urinating. In diseases of the genital organs, the prostate is usually affected, which can also trigger pain in the pelvic area, but is usually rather symptom-free.
Pelvic pain in the woman
As with men, women can get bony injuries from falls that cause pelvic pain. The spine is a typical way in which back pain can migrate into the pelvis. The intestinal diseases such as appendicitis, ulcerative colitis and Crohn's disease also cause pain in the pelvic area. There are also indigestion and general abdominal pain.
In addition, pelvic pain occurs in women, for example during pregnancy. Especially when the unborn child is a bit bigger, it displaces various organs so that these are somewhat narrowed in the pelvic area. Cystitis is also particularly common in women. This is due to the very short urethra, which allows bacteria to quickly ascend to the bladder. The female genital organs, which are located in the pelvic area, often trigger pelvic pain in women. These include various diseases of the uterus, and menstrual cramps lead to pelvic pain in some women. Ovarian disorders can also cause pelvic pain.
Symptoms
Pelvic pain can express themselves differently depending on the cause. The pain can a- or both sides occur, only with pressure arise on a certain point or especially under physical exertion to be felt. In addition, the pain can piercing or dull and also radiate into other parts of the body.
When next to the pain other physical symptoms consist like:
- general feeling of illness
- Exhaustion
- fever
- Signs of inflammation (Redness, swelling, overheating)
- unwanted weight loss
- or profuse sweating at night
so should consulted a doctor promptly to clarify the exact cause of the symptoms. It could be a serious illness hide behind it.
Same goes when the pain longer than a few days exist or yourself deteriorate drastically.
therapy
The Therapy of pelvic pain depends on the underlying cause.
- If the cause is in Musculoskeletal system is due to a blockage of the sacroiliac joint, for example, a chiropractor or a physiotherapist targeted adjustment Get relief.
- Bruises heal on their own. In severe pain you can Painkiller be taken.
- Broken bones must depending on the severity and type of fracture operational are supplied.Then help physiotherapy exercises in the process of regaining the original mobility.
If the cause of the discomfort is in Area of the pelvic organs is, an individually adapted therapy:
- In the case of a bladder infection, antibiotics are often used to fight the pathogens.
- Also infectious diseases the female or male genital organs may require antibiotics.
- Since an inflamed appendix can also cause pain in the lower abdomen and pelvic area (appendicitis), in this case the appendix must be operational removed.
- Malignant diseases that caused the pelvic pain are identified by a surgery, Chemotherapy and / or Irradiation treated.
forecast
The Prediction of pelvic pain depends heavily on the underlying root cause. Because such pain generally harmless in nature the prognosis is very good. In particular pain through Bruises, Contortions or Joint blockages often go away within a few days by itself again.
Infectious diseases of the pelvic organs are also afflicted with a good prognosis, as today's medical measures result in a fast and targeted treatment can be done.
Both malignant diseases it depends very much on the stage in which the patient is. in the Early stage there are often still good chances of recovery from cancer later stages the prognosis is accordingly worse. This also depends on the Age of the patient and his general health from.
prophylaxis
A general prophylaxis There is no such thing as avoiding pelvic pain. Sufficient physical activity and targeted strengthening exercises for the muscles, however, can help to minimize the risk of joint blockages or other problems with the musculoskeletal system.
Around Infections of the organs To avoid the small pelvis should be on a good but not excessive hygiene be respected.
To avoid sexually transmitted diseases, condoms should be used during sexual intercourse - especially outside of a stable relationship.
Malignant diseases cannot be prevented by prophylactic measures. Mostly lying genetic changes that cannot be influenced by the patient himself.
diagnosis
A thorough physical examination is necessary to diagnose pelvic pain. The doctor will take a close look at the relevant part of the body and look for any external signs. Various orthopedic tests can provide information on whether the pain is caused by a joint blockage or something similar.
In addition, the doctor can palpate the abdominal and pelvic organs and check them for pain. An ultrasound scan can also be done to look at the abdominal organs.
A urine or stool sample can help if you suspect an infectious disease of the bladder or intestines.
If all of these examinations are normal, imaging can also be ordered. In computed tomography (CT) particularly good for bones and in magnetic resonance imaging (MRI) the soft tissue can be examined particularly well.
Depending on the findings that result from these examinations, the doctor will initiate appropriate therapy.
