Chronic abdominal and pelvic pain is defined as pain in the lower abdomen, pelvis, or genital region that persists for more than 3 to 6 months. It may be constant or intermittent and can significantly interfere with daily function, sleep, and quality of life.
This type of pain is often complex and multifactorial, involving musculoskeletal, gynecological, gastrointestinal, urological, or neurologic components. A comprehensive evaluation and multidisciplinary treatment plan are essential for effective relief.
Common Causes of Chronic Abdominal and Pelvic Pain
In Women:
Endometriosis
Pelvic inflammatory disease (PID)
Ovarian cysts or fibroids
Interstitial cystitis (painful bladder syndrome)
Pelvic floor dysfunction
Post-surgical or post-hysterectomy pain
In Men:
Chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS)
Inguinal hernia or hernia repair-related pain
Pudendal neuralgia
In Both:
Irritable bowel syndrome (IBS)
Nerve entrapment syndromes (e.g., ilioinguinal, genitofemoral, pudendal nerves)
Adhesions from previous abdominal surgery
Central sensitization or neuropathic pain disorders
Symptoms
Burning, aching, or cramping pain in the abdomen or pelvis
Pain that may radiate to the lower back, thighs, or groin
Pain during or after urination, bowel movements, or sexual activity
Bloating, urgency, or pressure
Muscle spasms or pelvic floor tightness
Emotional distress such as anxiety, fatigue, or depression
Conservative Treatment Options
Medications
NSAIDs for inflammation and pain relief
Neuropathic agents (gabapentin, pregabalin, amitriptyline)
Muscle relaxants for pelvic floor spasm
Hormonal therapies (for endometriosis or gynecologic causes)
Antispasmodics or GI-directed medications (for IBS)
Pelvic Floor Physical Therapy
Biofeedback, manual therapy, and relaxation techniques
Addresses trigger points, muscle imbalance, and postural dysfunction
Behavioral and Psychological Therapies
Cognitive Behavioral Therapy (CBT), mindfulness, and coping strategies
Important for patients with central sensitization or emotional distress
Interventional Pain Management Options
When pain is resistant to conservative therapy, targeted interventional treatments can provide effective, longer-lasting relief:
Nerve Blocks
Pudendal Nerve Block – for pudendal neuralgia or pelvic floor pain
Ilioinguinal/Genitofemoral Nerve Blocks – for post-surgical groin or hernia-related pain
Hypogastric Plexus Block – for deep pelvic pain from gynecological, urological, or colorectal origins
Celiac Plexus Block – for upper abdominal visceral pain or GI-related disorders
Trigger Point Injections
For abdominal wall and pelvic floor muscle spasms contributing to pain
Botulinum Toxin (Botox®) Injections
Used in the pelvic floor muscles or abdominal wall to relieve chronic spasm and improve mobility
Radiofrequency Ablation (RFA)
Can be used for nerve ablation after successful diagnostic nerve blocks to achieve longer-term relief
Neuromodulation / Spinal Cord Stimulation (SCS)
Advanced treatment option for refractory pelvic or abdominal pain
Modulates pain signals at the spinal cord level to reduce chronic pain perception
When to Seek Help
You should consider seeing a specialist if you have:
Persistent abdominal or pelvic pain lasting more than 3 months
Pain unresponsive to medications, physical therapy, or lifestyle changes
Pain that impacts your mobility, bladder, bowel, or sexual function
A history of multiple surgeries with ongoing pain
Find Lasting Relief with a Personalized Plan
At Parkview Spine & Pain, we understand the complexity of chronic abdominal and pelvic pain. Our team specializes in advanced diagnostics and interventional therapies tailored to the unique needs of each patient. We work in collaboration with gynecology, urology, GI, and physical therapy providers to deliver comprehensive care.
👉 Schedule your consultation today to start your path toward lasting relief and restored function.