Common Causes of Pelvic Pain

February 10, 2014June 24, 2014 / Thomas Cohn, MD

Pelvic pain can occur in both men and women. It can be caused by a variety of conditions. Some of the more common causes of pelvic pain include:

Bladder infections such as interstitial cystitis
Hernias
Kidney stones
Bowel issues
Endometrial issues, and ovarian cysts (in women)

Treatment is based on the cause, and these pains usually resolve once the acute condition resolves. Read on the learn more about these specific conditions that can result in pelvic pain.

Endometriosis and Fibroids

Chronic pelvic pain in women is often related to several problems related to the unique pelvic anatomy. Endometriosis and fibroids are uterine tissue that forms outside the normal uterine location. Its growth is stimulated by the normal hormonal cycles. The tissue eventually causes scar tissue in the pelvic region and the scarring can cause diffuse pelvic pain. Surgery is often used to help resolve some of the problems related to this condition. Physical therapy and neuropathic medications can be helpful for long-term management.

Chronic Interstitial Cystitis

Chronic interstitial cystitis is an issue seen mainly in women with irritability of the bladder. The lining in the bladder becomes scarred, has pinpoint bleeding, and then becomes shrunken and stiff. Frequent urination (up to 60 or more times a day) and constant pelvic pain are common with chronic interstitial cystitis. Bladder distention is sometimes helpful and sometimes medication is instilled into the bladder. Bladder stimulators sometimes are implanted to help control symptoms.

Hernias

Hernias more commonly appear in men than in women. The muscle wall in the groin region weakens and abdominal contents push out of the area. Surgical repair is the treatment of choice, however there are nerves in the region that in 2% of the population can become entrapped in scar tissue and be painful. Physical therapy to release scarring, medications, and sometimes steroid injections are used to relieve symptoms.

Do Pain Medications Cause Kidney Stones?

February 5, 2014June 24, 2014 / Thomas Cohn, MD

Kidney stones are tiny pieces of mineral or salt in the urine that are incredibly painful when passed. Pain meds are often used to ease discomfort during stone passage. But can these pain medications also cause kidney stones?

What are Kidney Stones?

Kidney stones are considered one of the most painful acute conditions. They are caused by a variety of things such as:

How the body metabolizes various compounds (calcium, for example).
Not drinking enough water
Other medical conditions like gout
Genetic predisposition

As stones are passed from the kidney through the ureters to the bladder, they can be extremely painful. Stones are often as small as a grain of sand. As they are passed from the kidney they irritate the structures on the way out of the body.

Identifying & Preventing Kidney Stones

Stones are often suspected when there is blood in the urine without any additional signs of infection. In most cases, once you have a kidney stone you have no choice but to pass it. The only thing you can do is take pain meds to manage the pain during passage. In more severe cases, surgical procedure may be necessary to remove the stone. Analysis of the stone after it is passed can determine a prevention strategy moving forward.

Pain Medications & Kidney Stones

Pain medications are often used to control the extreme pain caused during the passage of a kidney stone. It is common that people when passing a stone have such severe pain that they go to a hospital. Powerful opioid and narcotic medications are useful to control the severe discomfort.

Pain medications themselves have not been known to cause kidney stones. They have been used as an essential tool in the treatment of acute passing of stones. Treatment is usually only necessary for a few hours to several days with opioid medications. In rare cases with people who have recurrent stones, frequent use of opioid medication on a temporary basis is necessary. This should only be a temporary solution until a renal specialist can develop a more definitive management strategy.

How to Prepare for a CT Scan

February 3, 2014June 24, 2014 / Thomas Cohn, MD

A CT scan is a medical imaging tool widely used by medical professionals to gain better insight into afflicted areas of the body. In this article, we’ll explain what a CT scan is, how it works, and how to best prepare for one.

For more information, read our blog on when CT scans, MRIs, and x-rays are useful in treating pain.

What is a CT Scan?

Computerized Tomography (CT) scans are a series of x-ray views taken of a body part at different angles. Computer processing of the views is used to create a cross-sectional picture of the scanned body part. A number of “slices” (x-ray images) are taken, and the computer combines the images to create a 3-dimensional view of the region examined. When the test was first introduced, the brain was the most common area examined by CT scan. Now, CT scans are used to examine many areas of the body.

When are CT Scans Helpful?

CT scans are x-ray images of a body region. Therefore, radiation exposure does occur during these studies. They are very fast to obtain and often provide very detailed information. CT scans are often used when detailed information is needed rapidly to make a diagnosis and initiate treatment. This makes them useful in acute illness, trauma, and brain injury where data needs to be collected fast and treatment cannot be delayed. MRI scans may provide more detailed information, but can take a long time to obtain. CT scans are also used in people who have metal implants in their bodies like pacemakers that can not placed in strong magnetic fields.

The risk of CT scans is similar to the risk associated with x-ray radiation. This is generally a small risk if exposure is limited. Frequent or multiple x-rays and CT scans can be a concern due to radiation and cancer. Scans also should not be done during pregnancy due to possible radiation damage to the fetus.

How to Prepare for a CT Scan

Preparing for a CT scan depends on the area being scanned. Since they are used in cases of trauma, often no special preparation is necessary. Sometimes, a special contrast is needed to increase visualization of an area. It may be swallowed, or injected in a vein or body cavity. The scanning process is fast, and the scanner is fairly open, so claustrophobia is generally not an issue. Most people will be required to wear a hospital gown for the scan so that clothing does not interfere with the imaging.

After the scan, a radiologist will interpret the results and report their findings to the doctor who ordered the scan (your physician). Combining the results of the scan with clinical information (including patient history and physical examination) is critical. Since the picture is only one part of the story, all the information needs to be combined to give an adequate explanation of the condition and the treatments that will work.