Features of chronic pelvic pain verification in clinical orthopedic practice


  • T.V. Orlyk Medical center “Poli-Clinic”, Kyiv, Ukraine




chronic pelvic pain, pelvic pain syndrome, “red flags”, musculoskeletal system, men, women, diagnostic algorithm, ­ICD-10


Chronic pelvic pain is a complex of pathological and biomechanical changes in the human body that requires a multidisciplinary approach to diagnosis and treatment, due to the high prevalence, underestimation and multifactorial development of this pathological condition. The article provides the overview information and a brief algorithm for chronic pelvic pain verification in men and women for clinical use in medical practice taking into account a comprehensive multidisciplinary approach by physicians of various specialties, including an orthopedist. Diagnostic features and key criteria for specific and nonspecific pelvic pain, pathophysiological mechanisms of chronic pain involving the central, peripheral and autonomic nervous systems, their relationship with the psycho-emotional disturbances are described. The special attention is paid to musculoskeletal pathology as a possible reason for pain and pelvic dysfunction, as well as its secondary changes against the background of gynecological, urological and proctological diseases. The participation of an orthopedist in the process of differentiation of both specific and non-specific pelvic pain is justified. The features of pelvic pain verification are based on international multidisciplinary protocols for its management indicating the pain syndromes according to II Classification of IASP Pain and possible classification diagnoses and codes, respectively, ICD-10.


Download data is not yet available.


Ahangari A. Prevalence of chronic pelvic pain among women: an updated review. Pain Physician. 2014;17(2):E141–E147.

Díaz-Mohedo E, Hita-Contreras F, Luque-Suárez A, Walker-Chao C, Zarza-Luciáñez D, Salinas-Casado J. Prevalence and risk factors of pelvic pain. Actas Urol Esp. 2014;38(5):298–303. https://doi.org/10.1016/j.acuro.2013.09.006.

Hedelin H, Johannisson H, Welin L. Prevalence of the chronic prostatitis/chronic pelvic pain syndrome among 40-69-year-old men residing in a temperate climate. Scand J Urol. 2013;47(5):390–392. https://doi.org/10.3109/00365599.2012.756930.

Passavanti MB, Pota V, Sansone P, Aurilio C, De Nardis L, Pace MC. Chronic Pelvic Pain: Assessment, Evaluation, and Objectivation. Pain Res Treat. 2017;2017:9472925. https://doi.org/10.1155/2017/9472925.

Royal College of Obstetricians and Gynaecologists (RCOG). The Initial Management of Chronic Pelvic Pain: Green-top Guideline 41. Available from: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg41/. Accessed: May 25, 2012.

Fante JF, Silva TD, Mateus-Vasconcelos ECL, Ferreira CHJ, Brito LGO. Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? Rev Bras Ginecol Obstet. 2019;41(8):508–519. https://doi.org/10.1055/s-0039-1695002.

Ayorinde AA, Bhattacharya S, Druce KL, Jones GT, Macfarlane GJ. Chronic pelvic pain in women of reproductive and post-reproductive age: a population-based study. Eur J Pain. 2017;21(3):445–455. https://doi.org/10.1002/ejp.938.

ACOG Committee on Practice Bulletins – Gynecology. ACOG Practice Bulletin No. 51. Chronic pelvic pain. Obstet Gynecol. 2004;103(3):589–605.

Royal College of Obstetricians and Gynaecologists (RCOG). The Initial Management of Chronic Pelvic Pain: Green-top Guideline 41. Available from: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg41/. Accessed: May 25, 2012.

Jarrell JF, Vilos GA, Allaire C, et al. Consensus guidelines for the management of chronic pelvic pain. J Obstet Gynaecol Can. 2005;27(8):781–826. https://doi.org/10.1016/s1701-2163(16)30732-0.

Engeler D, Baranowski AP, Berghmans B, et al. Chronic Pelvic Pain. Available from: https://uroweb.org/guideline/chronic-pelvic-pain/.

World Health Organization (WHO). ICD-10: Instruction manual. Vol 2. Available from: https://www.who.int/classifications/icd/icdonlineversions/en/.

International Association for the Study of Pain (IASP). Classification of Chronic Pain. 2nd ed. Available from: https://www.iasp-pain.org/PublicationsNews/Content.aspx?ItemNumber=1673.

Cox A, Golda N, Nadeau G, et al. CUA guideline: Diagnosis and treatment of interstitial cystitis/bladder pain syndrome. Can Urol Assoc J. 2016;10(5-6):E136–E155. https://doi.org/10.5489/cuaj.3786.

Davenport RB, Voutier CR, Veysey EC. Outcome Measurement Instruments for Provoked Vulvodynia: A Systematic Review. J Low Genit Tract Dis. 2018;22(4):396–404. https://doi.org/10.1097/lgt.0000000000000418.

Van de Merwe JP, Nordling J, Bouchelouche P, et al. Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol. 2008;53(1):60–67. https://doi.org/10.1016/j.eururo.2007.09.019.

National Institute for Health and Care Excellence (NICE). Irritable bowel syndrome in adults: diagnosis and management; Clinical guideline CG61. Available from: https://www.nice.org.uk/guidance/cg61. Accessed: April 2017.

National Institute for Health and Care Excellence (NICE). Constipation in children and young people: diagnosis and management: Clinical guideline CG99. Available from: https://www.nice.org.uk/guidance/cg99. Accessed: July 2017.

National Institute for Health and Care Excellence (NICE). Faecal incontinence in adults: management: Clinical guideline CG49. Available from: https://www.nice.org.uk/guidance/cg49. Accessed: June 2007.

Orlyk TV. Differentiated approach to the diagnostics of women`s back pain: postmenopausal osteoporosis in focus. Slovo pro zdorov'ja. 2018;(18):42–48. (in Ukrainian).

Blok B, Castro-Diaz D, Del Popolo G, et al. Neuro-Urology. Available from: https://uroweb.org/guideline/neuro-urology/.

Barinov AN. Diagnosis and treatment of pelvic pain. Meditsinskiy sovet. 2015;(10):66–76. https://doi.org/10.21518/2079-701X-2015-10-66-76. (in Russian).

Evans S. Management of persistent pelvic pain in girls and women. Aust Fam Physician. 2015;44(7):454–459.

Gyang A, Hartman M, Lamvu G. Musculoskeletal causes of chronic pelvic pain: what a gynecologist should know. Obstet Gynecol. 2013;121(3):645–650. https://doi.org/10.1097/aog.0b013e318283ffea.

Podichetty VK, Mazanec DJ, Biscup RS. Chronic non-malignant musculoskeletal pain in older adults: clinical issues and opioid intervention. Postgrad Med J. 2003;79(937):627–633. https://doi.org/10.1136/pmj.79.937.627.




How to Cite

Orlyk, T. (2021). Features of chronic pelvic pain verification in clinical orthopedic practice. PAIN, JOINTS, SPINE, 10(1), 47–50. https://doi.org/10.22141/2224-1507.10.1.2020.199723



Practical Medicine