Female Pain
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Female Pain
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As-Sanie S. Causes of chronic pelvic pain in nonpregnant women. https://www.uptodate.com/contents/search. Accessed May 9, 2019.
Tu FF, et al. Treatment of chronic pelvic pain in women. https://www.uptodate.com/contents/search. Accessed May 9, 2019.
AskMayoExpert. Pelvic pain. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
Elkadry E, et al. Clinical manifestations and diagnosis of myofascial pelvic pain syndrome in women. Evaluation of chronic pelvic pain in women. https://www.uptodate.com/contents/search. Accessed May 9, 2019.
Frequently asked questions. Gynecologic problems FAQ099. Chronic pelvic pain. American Congress of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq099.pdf?dmc=1&ts=20130418T1809515975. Accessed April 8, 2016.
Tu FF, et al. Evaluation of chronic pelvic pain in women. https://www.uptodate.com/contents/search. Accessed May 9, 2019.
Interstitial cystitis/painful bladder syndrome. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/interstitialcystitis/index.htm. Accessed April 8, 2016.
Carinci AJ. Complementary and alternative treatments for chronic pelvic pain. Current Pain and Headache Reports. 2013;17:316.
Cheong YC, et al. Non-surgical interventions for the management of chronic pelvic pain. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/wol1/doi/10.1002/14651858.CD008797.pub2/abstract. Accessed April 8, 2016.
Relaxation techniques for health: An introduction. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/sites/nccam.nih.gov/files/relaxation_introduction.pdf.Accessed April 8, 2016.
AskMayoExpert. Endometriosis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
Endometriosis. Womenshealth.gov. http://www.womenshealth.gov/publications/our-publications/fact-sheet/endometriosis.html. Accessed April 12, 2016.
AskMayoExpert. Painful bladder syndrome. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
Kotarinos RK. Pelvic floor physical therapy for management of myofascial pelvic pain syndrome in women. https://www.uptodate.com/contents/search. Accessed May 9, 2019.
Hunter C, et al. Neuromodulation of pelvic visceral pain: Review of the literature and case series of potential novel targets for treatment. Pain Practice. 2013;13:3.
Acupuncture: In-depth. National Center for Complementary and Alternative Medicine. https://nccih.nih.gov/health/acupuncture/introduction. Accessed April 8, 2016.
Speer LM, et al. Chronic pelvic pain in women. American Family Physician. 2016;93:380.
Engeler D, et al. Guidelines on chronic pelvic pain. European Association of Urology. https://uroweb.org/guideline/chronic-pelvic-pain/. Accessed May 9, 2019.
Butler Tobah YS (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 23, 2017.
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Chronic pelvic pain is pain in the area below your bellybutton and between your hips that lasts six months or longer.
Chronic pelvic pain can have multiple causes. It can be a symptom of another disease, or it can be a condition in its own right.
If your chronic pelvic pain appears to be caused by another medical problem, treating that problem may be enough to eliminate your pain.
However, in many cases it's not possible to identify a single cause for chronic pelvic pain. In that case, the goal of treatment is to reduce your pain and other symptoms and improve your quality of life.
When asked to locate your pain, you might sweep your hand over your entire pelvic area rather than point to a single spot. You might describe your chronic pelvic pain in one or more of the following ways:
Your discomfort may intensify after standing for long periods and may be relieved when you lie down. The pain may be mild and annoying, or it may be so severe that you miss work, can't sleep and can't exercise.
With any chronic pain problem, it can be difficult to know when you should go to the doctor. In general, make an appointment with your doctor if your pelvic pain disrupts your daily life or if your symptoms seem to be getting worse.
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Chronic pelvic pain is a complex condition that can have multiple causes. Sometimes, a single disorder may be identified as the cause.
In other cases, however, pain may be the result of several medical conditions. For example, a woman might have endometriosis and interstitial cystitis, both of which contribute to chronic pelvic pain.
Some causes of chronic pelvic pain include:
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Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade.
Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health.
Groin pain is fairly common in women and can have a wide variety of causes. A few of the possible causes of pain in the groin area include a pulled muscle, a urinary tract infection, and osteoarthritis .(OA). Groin pain can also be related to pregnancy.
This article discusses 14 common causes of groin pain in women and how each one is treated.
One of the most common causes of pain in the groin is a muscle strain .
A strain (also known as a pull) occurs when a muscle is overstretched and either partially or completely torn. When this occurs in the groin, it typically involves a group of muscles called your adductors, which are located on the inside of your thigh.
Any one of the five adductor muscles (the adductor magnus, adductor brevis, pectineus, adductor longus, and the gracilis ) may be involved. 1
This type of injury typically occurs while performing a sport or exercise that involves:
In addition to pain in the groin, a strain can make lifting your leg or moving your thigh closer to your other leg painful.
Depending on how serious it is, you may hear a popping noise during the strain. You may also develop bruising or swelling.
Mild strains typically only limit your ability to do more advanced exercises or activities. Severe sprains can cause pain while you walk or even while you are at rest. 1
Most groin strains heal on their own. However, healing can take up to eight weeks for more severe injuries.
To help with recovery, your primary healthcare provider may suggest: 1
Another common cause of groin pain is osteoarthritis of the hip .
OA in the hip occurs when the smooth cartilage on the end of the ball (femoral head) and socket ( acetabulum ) portions of the hip joint begins to thin and wear away. This causes increased friction with hip movement and can lead to a buildup of excess bone.
Over time, OA can also lead to pain in the thigh and buttocks. 2
Osteoarthritis typically occurs in middle-aged or older people. It is more common in women.
The pain from OA is typically worse in the morning and after a long period of activity.
Other symptoms that make it different from a muscle strain include: 2
OA can usually be treated by your primary healthcare provider, who may suggest managing your symptoms with:
If these types of treatments fail, surgery may be necessary. In this case, an orthopedic surgeon typically performs a resurfacing procedure . This is done by covering or capping the femoral head with a metal shell. Another option is a total hip replacement . 2
Hip impingement, also known as femoroacetabular impingement (FAI) is another bone-related condition that can lead to groin pain.
This occurs when extra bone growth on either the acetabulum or femoral head portion of the hip causes the joint to take on an irregular shape. This, in turn, causes pain and joint damage when you move your leg.
The pain from hip impingement is typically centered in the groin, but it can also extend to the outside of the hip.
The soreness is usually deep within the joint and is frequently made worse with movements like bringing your knees toward your chest or crossing your leg. Tasks involving squatting or twisting may also be painful.
In more severe cases, an orthopedic surgeon may need to perform surgery on the joint itself. This procedure typically involves removing the excess bone growth on the femoral head or acetabulum and cleaning up any damage it has caused within the hip. 3
In some cases, the pain in your groin could be caused by a condition called a sports hernia . This is also known as athletic pubalgia . This is a broad term referring to any strain or sprain of a ligament, muscle, or tendon in the lower stomach or groin region.
Although it is similarly named, a sports hernia differs from a hiatal hernia or an inguinal hernia . These involve the bulging of fat or organs through a weak area of muscle or connective tissue. 4
Sports hernias, like adductor strains, traditionally occur while playing activities like hockey or soccer that involve a lot of cutting or quick changes in direction. The groin pain associated with athletic pubalgia is usually severe while playing sports or exercising, but better with rest.
Unlike a hiatal hernia, there is not a palpable bulge in the area of injury (though sports hernias may eventually lead to a hiatal hernia if left untreated).
The typical treatment for this condition is similar to the treatment for an adductor strain, including: 4
Middle-aged and older women, particularly those who have already gone through menopause , are at a much higher risk of developing osteoporosis. This condition, which causes decreased bone density throughout the body, puts you at a higher risk of experiencing a bone fracture.
One of the most common locations where this can occur is the hip. Fractures in this area typically affect the femur bone in the region just below the femoral head. This type of bone break (called an insufficiency fracture) can occur even after a small fall or twist injury. In some cases, the bone is so brittle that even the act of standing or walking can break it.
Hip fractures typically lead to immediate, sharp pain in the groin or upper thigh region. This extreme pain usually makes it nearly impossible to bear weight on your leg. 5
If you suspect a fracture, you should have your hip looked at by a healthcare provider right away.
This type of injury is diagnosed with an X-ray. It usually needs to be surgically stabilized within a day or two by an orthopedic surgeon to prevent further damage from occurring. 5
Urinary tract infections (UTI) occur when bacteria entesr the body via the urethra (the tube through which urine leaves your body) and infects your urinary tract. This issue is more common in:
UTIs can cause a cramping sensation in your groin or the lower portion of your stomach. Other symptoms of a UTI include:
Most urinary tract infections are easily treated with an antibiotic, so it is important to speak to a healthcare provider if you suspect you have one. 6
The appendix is a small, tube-shaped structure located in the lower portion of the right side of the abdomen. While this organ serves no useful purpose, in some cases it can become infected or inflamed. This condition, known as appendicitis , usually affects people in their teens or 20s and is considered a medical emergency. 7
The pain from appendicitis is typically located on the right side of the lower portion of the stomach near the groin. The pain may come and go at first, but as it progresses it becomes severe, especially if the appendix ultimately ruptures. 7
Along with sharp pain, appendicitis can cause:
Once the appendicitis is diagnosed with an MRI or CT scan, the appendix is typically removed by a general surgeon with a laparoscopic procedure .
If the organ ruptures, however, a more complex abdominal surgery may be needed. Because of this, it is important to see a healthcare provider immediately if you think you may have appendicitis. 7
Throughout your body, a series of bean-shaped nodules called lymph nodes form the lymphatic system. This complex network helps transport nutrients and waste in lymph fluid between the body’s tissue and your bloodstream.
Occasionally, an infection or injury in the body causes the lymph nodes to become swollen and painful to the touch. Rarely, swollen lymph nodes may indicate a tumor.
One location where this lymph node enlargement is frequently seen is the groin. Nodes in the groin region (called the inguinal or femoral lymph nodes) may grow in size as a result of an injury or infection in your foot, leg, groin, or vagina.
Swollen lymph nodes are frequently able to be felt under the skin.
While lymph nodes can vary in size, a severely enlarged one can grow to the size of a small olive.
Usually, treating the underlying injury or infection helps to reduce lymph node pain and swelling. 8 Occasionally, however, a physical therapist who is skilled in treating lymphedema (swelling of the lymph nodes) may also be needed to resolve this condition.
A kidney stone is a small mass of miniature, crystal-like structures that originates in the kidney. These structures occasionally travel from the kidney to the bladder via a tube called the ureter.
Because the ureter is quite narrow, the sharp edges of the stone can scrape against the tube’s walls and cause excruciating pain in the groin or vaginal area. Sharp pain in your stomach or on the side of your back may also occur.
The severe pain from a kidney stone can come and go.
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