What Is Pelvic Pain?

Pelvic pain is pain that occurs in the lower abdomen, pelvis, or genital region. It may be acute — meaning it comes on suddenly and resolves within a short period — or chronic, meaning it persists for three months or longer. Chronic pelvic pain is one of the most complex and underdiagnosed pain conditions because it can stem from multiple overlapping causes and affect multiple organ systems simultaneously.

Pelvic pain can range from a mild, intermittent ache to severe, constant pain that prevents normal movement or function. It may worsen with certain activities such as sitting, sexual intercourse, urination, or bowel movements. For some patients, the pain is cyclical and tied to hormonal changes; for others, it is constant and unpredictable. Regardless of how it presents, chronic pelvic pain deserves thorough evaluation and expert management.

What Causes Pelvic Pain?

Pelvic pain can arise from a wide variety of sources, which is why an accurate diagnosis is so important. At Olympus Spine and Pain, Dr. Warner performs a comprehensive evaluation to identify the underlying cause before recommending treatment. Common causes of pelvic pain include:

Gynecological conditions — In women, pelvic pain is frequently associated with endometriosis, uterine fibroids, ovarian cysts, and pelvic inflammatory disease (PID). These conditions cause chronic inflammation, hormonal disruption, and structural changes in the pelvic region that generate persistent pain.

Musculoskeletal conditions — Pelvic floor dysfunction, muscle spasm, hernias, and sciatica can all produce significant pelvic pain. When the muscles, ligaments, and connective tissues of the pelvic floor are too tight, too weak, or poorly coordinated, they can create ongoing pain that is often mistaken for organ-related conditions.

Urological causes — Urinary tract infections, interstitial cystitis (painful bladder syndrome), and prostatitis in men are common urological sources of pelvic pain. These conditions can cause both pelvic and lower abdominal discomfort that may be associated with urinary urgency, frequency, or difficulty.

Digestive conditions — Irritable bowel syndrome (IBS), Crohn’s disease, diverticulitis, and constipation can all cause pelvic pain through bowel inflammation, spasm, or obstruction. Digestive-related pelvic pain often worsens after eating and may improve after a bowel movement.

Neurological and chronic pain conditions — Pudendal neuralgia, pelvic nerve entrapment, fibromyalgia, and complex regional pain syndrome (CRPS) can all contribute to pelvic pain by sensitizing the nerves that serve the pelvic region. These conditions often require specialized interventional pain management.

When Do I Need Pain Management for Pelvic Pain?

If your pelvic pain has persisted for more than a few weeks, is worsening, or is affecting your sleep, work, relationships, or emotional well-being, it is time to seek specialized care. Chronic pelvic pain rarely resolves on its own without targeted treatment, and the longer it is left unaddressed, the more the nervous system can become sensitized — making the pain harder to treat over time. Do not wait for the pain to become unbearable. Early intervention at Olympus Spine and Pain gives you the best chance of a successful outcome.

How Is Chronic Pelvic Pain Treated at Olympus Spine and Pain?

Chronic pelvic pain treatment at Olympus Spine and Pain is always individualized. Dr. Warner performs a comprehensive diagnostic review and discusses all available options with you before recommending a plan. Because pelvic pain often involves multiple contributing factors, treatment typically combines several approaches, which may include:

• Medications tailored to the specific underlying condition
• Sympathetic nerve blocks to interrupt pelvic pain signaling pathways
• Pudendal nerve blocks for pudendal neuralgia and pelvic floor dysfunction
• Peripheral nerve stimulation — an implanted device that intercepts pain signals at the nerve level
• Spinal cord stimulation — an implanted device that masks chronic pain signals before they reach the brain
• Intrathecal drug pump for targeted, continuous medication delivery
• Ketamine infusions* for patients with refractory or centrally sensitized pelvic pain
• Scrambler Therapy — a non-invasive neuromodulation option for neuropathic pelvic pain
• Physical therapy focused on pelvic floor rehabilitation
• Cognitive behavioral therapy (CBT) to address the psychological dimensions of chronic pain

If your pelvic pain has an abdominal component, Dr. Warner will address both simultaneously to ensure comprehensive relief. His goal is always to restore your comfort, function, and quality of life through the most effective and minimally invasive means possible.

*Ketamine infusions are FDA-approved as a sole anesthetic agent for diagnostic and surgical purposes, but are not yet approved for chronic pain treatment. Spravato®, an esketamine nasal spray, has FDA approval for addressing treatment-resistant depression.

Pelvic Pain — Frequently Asked Questions