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