GYNECOLOGY

Pelvic floor dysfunction

  • Pelvic floor dysfunction is a well-known musculoskeletal cause of CPP.
  • It occurs when pelvic floor muscles are either too weak or too tight. 
  • The major contributing factors include
    • Obesity
    • Menopause
    • Pregnancy
    • childbirth. 
  • Causes
    • ?inherited collagen deficiency – are at risk of stress urinary incontinence and pelvic organ prolapse.
  • Diagnosis
    • Pelvic floor muscle palpation (PMP)
      • firm transvaginal digital palpation of the right and left pelvic floor muscles elicits pain
    • The forced Flexion, Abduction and External Rotation test (fFAER)
      • pain is elicited by flexion, abduction and external rotation of either leg from the supine position 
    • The presence of both findings correctly identifies patients with musculoskeletal disorders contributing to CPP in 85% of the time while the absence of both findings has 100% specificity
  • Treatment
    • Physiotherapy is typically beneficial in relieving symptoms of the musculoskeletal origin 

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