WIN Webinar: Managing Pelvic Pain (Enduring)-WIN Webinar: Managing Pelvic Pain (Enduring)

Video Transcription

Video Summary

This webinar on managing pelvic pain, hosted by NANS and the Women in Neuromodulation Committee, emphasized that pelvic pain is common, costly, and often misattributed to a single cause. The speakers stressed a biopsychosocial, multidisciplinary approach because pelvic pain usually involves overlapping contributors from muscles, nerves, organs, bones, and the central nervous system.<br /><br />The presentation reframed pelvic pain as a “muscles, nerves, and bones” problem after ruling out major gynecologic, urologic, gastrointestinal, and other visceral causes. It reviewed relevant anatomy in both women and men, highlighted important peripheral nerves and nerve roots, and discussed the role of the sympathetic nervous system and musculoskeletal structures such as the hip, SI joint, coccyx, and abdominal wall.<br /><br />A practical clinic workflow was outlined: detailed history, attention to urinary, bowel, sexual, and psychological factors, followed by targeted physical examination including Carnett’s test, pelvic floor assessment, and evaluation for trigger points or nerve distribution pain. The speakers recommended selective imaging and referrals rather than broad testing, with strong emphasis on coordinating care across gynecology, urology, GI, colorectal, pelvic floor physical therapy, and mental health.<br /><br />Treatment options reviewed included lifestyle modification, pelvic floor physical therapy, medications, trigger point injections, peripheral nerve blocks, sympathetic blocks, radiofrequency ablation, TENS, and neuromodulation techniques such as DRG stimulation, spinal cord stimulation, and peripheral nerve stimulation. Multiple case examples illustrated how individualized, multimodal treatment can improve function and quality of life even in longstanding, complex pain syndromes.

Keywords

pelvic pain

neuromodulation

pelvic floor physical therapy

biopsychosocial approach

multidisciplinary care

peripheral nerve blocks

sympathetic nervous system

trigger point injections

spinal cord stimulation

dorsal root ganglion stimulation