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Pelvic Pain, An Issue of Physical Medicine and Rehabilitation Clinics of North America, E-Book

Pelvic Pain, An Issue of Physical Medicine and Rehabilitation Clinics of North America, E-Book

Kelly Scott

(2017)

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Book Details

Abstract

This issue focuses on Pelvic Pain. Article topics include: Pelvic Pain-an overview; Anatomy and Physiology of the Pelvic Floor; Office Examination of Neuromuscular Pelvic Pain; Diagnostic Studies for Neuromuscular Pelvic Pain; Pelvic Floor Myofascial Pain and Associated Disorders; Bony and Ligamentous Causes of Pelvic Pain; Coccydynia;Neurogenic Pelvic Pain; Urologic and Gynecologic Sources of Pelvic Pain; Physical Therapy for the Treatment of Pelvic Pain; and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Pelvic Pain\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents vii
Foreword vii
Preface: Pelvic Pain vii
Pelvic Pain: An Overview vii
Anatomy and Physiology of the Pelvic Floor\r vii
Office Evaluation of Pelvic Pain vii
Diagnostic Evaluation of Chronic Pelvic Pain viii
Myofascial Pelvic Pain and Related Disorders viii
Musculoskeletal Approach to Pelvic Pain viii
Coccydynia: Tailbone Pain viii
Neurogenic Pelvic Pain ix
Urologic and Gynecologic Sources of Pelvic Pain ix
Physical Therapy Treatment of Pelvic Pain ix
Iatrogenic Pelvic Pain: Surgical and Mesh Complications ix
Interventional Management for Pelvic Pain x
PHYSICAL MEDICINEANDREHABILITATION\rCLINICS OF NORTH AMERICA\r xi
FORTHCOMING ISSUES xi
November 2017 xi
February 2018 xi
May 2018 xi
RECENT ISSUES xi
May 2017 xi
February 2017 xi
November 2016 xi
Foreword xiii
Pelvic Pain xv
Pelvic Pain 449
Key points 449
EPIDEMIOLOGY 450
DISABILITY 450
Risk Factors for Chronic Pelvic Pain 450
Acute-on-Chronic and Red Flags 451
Differential Diagnoses 451
EVALUATION 451
ASSOCIATED CONDITIONS THAT ACCOMPANY PELVIC PAIN 452
SUMMARY 453
REFERENCES 453
Anatomy and Physiology of the Pelvic Floor 455
Key points 455
INTRODUCTION 455
ANATOMY OF THE PELVIC FLOOR 455
PHYSIOLOGY OF THE PELVIC FLOOR 458
SUMMARY 460
REFERENCES 460
Office Evaluation of Pelvic Pain 461
Key points 461
INTRODUCTION 461
THE CLINICAL HISTORY 462
THE CLINICAL PHYSICAL EXAMINATION 466
ABDOMINAL EXAMINATION 467
Inspection 467
Auscultation 467
Palpation 467
Special Tests 467
NEUROLOGIC EXAMINATION 467
MUSCULOSKELETAL EXAMINATION 468
Diagnostic Evaluation of Chronic Pelvic Pain 477
Key points 477
INTRODUCTION 477
PELVIC ORGANS 478
Endometriosis 478
Adenomyosis 480
Uterine Fibroids 481
Pelvic Congestion Syndrome 481
Chronic Infection 483
Other Intrapelvic Causes of Pain 483
PELVIC FLOOR DYSFUNCTION 485
PELVIC FLOOR SYNTHETIC MATERIAL 486
NEUROGENIC PAIN 488
Imaging of Neurogenic Pain: Magnetic Resonance Neurography 489
Nonimaging Evaluation of Pelvic Pain 493
Nerve conduction studies 493
Sacral reflexes 494
Needle electromyography 495
Utility of electrodiagnostic tests for pelvic pain 495
SUMMARY 496
ACKNOWLEDGMENTS 496
REFERENCES 496
Myofascial Pelvic Pain and Related Disorders 501
Key points 501
DEFINITION AND EPIDEMIOLOGY 501
ANATOMY 502
HISTORY 502
PHYSICAL EXAMINATION 503
DIAGNOSIS AND DIAGNOSTIC TESTING 503
TREATMENT 504
Physical Therapy 505
Conservative Treatment 506
Medications 506
Injections 506
Local anesthetic myofascial trigger points injection 507
Botulinum toxin-A 507
Dry needling 508
Neuromodulation Therapy 508
ASSOCIATED DISORDERS 508
Gynecologic 508
Urologic 510
Gastrointestinal 510
Musculoskeletal Disorders 511
Psychosocial Disorders 511
SUMMARY/DISCUSSION 512
REFERENCES 512
Musculoskeletal Approach to Pelvic Pain 517
Key points 517
INTRODUCTION 517
SACROILIAC JOINT PAIN 518
Anatomy 518
Clinical Presentation 518
Diagnostic Evaluation 519
Physical examination 519
Diagnostic testing 520
Treatment 520
PUBIC SYMPHYSIS PAIN 520
Anatomy 521
Clinical Presentation 521
Diagnostic Evaluation 522
Physical examination 522
Diagnostic testing 522
Treatment 522
Pubic symphysis pain 522
Core muscle injury 523
PELVIC INSUFFICIENCY FRACTURES/BONE STRESS INJURIES 523
Clinical Presentation 523
Diagnostic Evaluation 523
Physical examination 523
Diagnostic testing 523
Treatment 524
HIP DISORDERS 524
Clinical Presentation 525
Diagnostic Evaluation 526
Physical examination 526
Diagnostic testing 526
Treatment 526
PIRIFORMIS SYNDROME 528
Anatomy 528
Clinical Presentation 528
Diagnostic Evaluation 528
Physical examination 528
Diagnostic testing 529
Treatment 529
HIP FLEXOR TENDINOPATHY 529
Anatomy 529
Clinical Presentation 529
Diagnostic Evaluation 530
Physical examination 530
Diagnostic testing 530
Treatment 530
GREATER TROCHANTERIC PAIN SYNDROME 530
Anatomy 530
Clinical Presentation 531
Diagnostic Evaluation 531
Physical examination 531
Diagnostic testing 531
Treatment 531
ISCHIOFEMORAL IMPINGEMENT SYNDROME 532
Anatomy 532
Clinical Presentation 532
Diagnostic Evaluation 532
Physical examination 532
Diagnostic testing 532
Treatment 532
PELVIC FLOOR DYSFUNCTION 533
SUMMARY 533
REFERENCES 533
Coccydynia 539
Key points 539
INTRODUCTION 539
EPIDEMIOLOGY 539
ANATOMY 540
CAUSES OF TAILBONE PAIN 541
Coccyx Fractures 541
Coccyx Dislocations 541
Coccygeal Dynamic Instability 541
Distal Coccyx Bone Spurs 541
Abnormal Backward Position of Coccygeal Bones 542
Abnormally Excessive Forward Flexion of the Coccygeal Bones 542
Coccygeal Arthritis 542
Sympathetic Nervous System Pain 542
Pelvic Floor Dysfunction 542
Cancer 542
Osteomyelitis 542
SYMPTOMS OF COCCYDYNIA 542
Pain with Sitting 542
Pain During Sit-to-Stand 543
Other Lumbosacral Pain Syndromes, Occurring Concomitantly with Coccydynia 543
PHYSICAL EXAMINATION FOR COCCYDYNIA 543
Patient Pointing 543
Visual Inspection 543
Coccyx Palpation 543
Adjacent Palpation 543
PHYSICAL EXAMINATION FOR CONCOMITANT LUMBOSACRAL CONDITIONS 544
MEDICAL TESTS FOR COCCYDYNIA 544
Radiographs 544
Sitting-Versus-Standing Radiographs 544
MRI 544
Computerized Tomography Scans 544
Nuclear Medicine Bone Scans 544
TREATMENT OF COCCYDYNIA 545
Coccyx Cushions 545
Modalities and Topical Medications 545
Oral Medications 545
Interventional Pain Management Injections 546
Coccygeal Manipulation 546
Physical Therapy 546
Coccygectomy 547
SUMMARY 547
REFERENCES 547
Neurogenic Pelvic Pain 551
Key points 551
INTRODUCTION 551
ANATOMY OF PELVIC NERVES 552
ILIOHYPOGASTRIC, ILIOINGUINAL, AND GENITOFEMORAL NEURALGIA 553
Introduction 553
Epidemiology and Etiology 553
Patient Evaluation 554
Treatment Options 555
PUDENDAL NEURALGIA 555
Introduction 555
Epidemiology and Etiology 556
Patient Evaluation 556
Treatment Options 558
CLUNEALGIA 559
Introduction 559
Epidemiology and Etiology 559
Patient Evaluation 559
Treatment 560
TARLOV CYSTS 560
Introduction 560
Epidemiology and Etiology 560
Patient Evaluation 561
Treatment 561
CAUDA EQUINA SYNDROME 562
Introduction 562
Epidemiology and Etiology 562
Patient Evaluation 562
Treatment 563
SUMMARY 563
REFERENCES 563
Urologic and Gynecologic Sources of Pelvic Pain 571
Key points 571
VULVAR AND VAGINAL PAIN 572
UTERINE AND CERVICAL SOURCES OF PAIN 576
OVARIAN AND ADNEXAL PAIN 579
BLADDER PAIN 580
URETHRAL PAIN 582
URETER/KIDNEY/PROSTATE PAIN 583
REFERENCES 585
Physical Therapy Treatment of Pelvic Pain 589
Key points 589
INTRODUCTION 589
ROLE OF PHYSICAL THERAPY IN THE ASSESSMENT OF PELVIC GIRDLE FUNCTION IN THE PRESENCE OF PAIN 591
PHYSICAL THERAPY TREATMENT OF PELVIC PAIN 593
Postural Correction and Muscle Flexibility Restoration 595
BIOFEEDBACK TRAINING 596
MANUAL THERAPY, MYOFASCIAL RELEASE, AND TRIGGER POINT MASSAGE 597
THERAPEUTIC EXERCISE 597
DESENSITIZATION 597
PHYSICAL THERAPY TECHNIQUES FOR SEXUAL DYSFUNCTION 598
LIFESTYLE AND BEHAVIOR MODIFICATIONS 598
EVIDENCE FOR PELVIC FLOOR PHYSICAL THERAPY 599
SUMMARY 599
REFERENCES 599
Iatrogenic Pelvic Pain 603
Key points 603
INTRODUCTION 603
VAGINAL AND URETHRAL NEURO-ANATOMY 604
Obturator Nerve 605
Pudendal Nerve 605
ETIOLOGY OF PAIN RELATED TO MESH PLACEMENT 606
EVALUATIONS/APPROACH TO DIAGNOSIS 608
MANAGEMENT AND OUTCOMES 611
Surgical Technique of Transvaginal Mesh Excision 611
Surgical Technique of Mid-urethral Sling Excision 612
MANAGEMENT AND OUTCOMES 613
CONSERVATIVE MANAGEMENT OF CHRONIC PELVIC PAIN 615
COMPLICATIONS 616
SUMMARY 616
REFERENCES 616
Interventional Management for Pelvic Pain 621
Key points 621
INTRODUCTION 621
SUPERIOR HYPOGASTRIC PLEXUS BLOCK 621
INFERIOR HYPOGASTRIC PLEXUS BLOCK 623
GANGLION IMPAR BLOCK 624
TRANSVERSUS ABDOMINIS PLANE BLOCK 627
ILIOINGUINAL, ILIOHYPOGASTRIC, AND GENITOFEMORAL NERVE BLOCK 628
PUDENDAL BLOCK 632
SELECTIVE NERVE ROOT BLOCK 634
TRIGGER POINT INJECTION 635
SACROILIAC JOINT INJECTION 638
NEUROMODULATION 640
SUMMARY 643
REFERENCES 643
Index 647