A Sordid Tale of Musculoskeletal Dysfunction

When pelvic pain strikes, the impact is catastrophic. In this talk, we will uncover how the musculoskeletal system contributes to this debilitating condition. Pelvic floor muscle dysfunction is associated with pelvic pain, and prevalence estimates in various pelvic pain conditions, including endometriosis, vulvodynia, and painful bladder syndrome, range from 21% to a whopping 80%. Musculoskeletal pelvic pain negatively affects sexual and physical function, activities of daily living, and health related quality of life. To complicate the issue, pain coming from the pelvic floor muscles may refer to other body parts such as the lumbar spine, sacroiliac joints, hips, and abdomen. When pelvic pain becomes chronic, women may also show signs of maladaptive neuronal plasticity associated with widespread muscle pain beyond just the proximal pelvic region. Despite the high prevalence of musculoskeletal pelvic pain, medical and rehabilitative providers do not routinely screen for musculoskeletal dysfunction, leaving patients with limited access to providers skilled in managing musculoskeletal pelvic pain. This talk will provide an overview of key abdominopelvic musculature and its contributions to pelvic pain, screening for musculoskeletal dysfunction, and components of a musculoskeletal pelvic pain examination. (Recorded at PAINWeek 2017)