Pelvic Pain Diagnosis/Treatment

Pelvic pain is an uncommon but significant problem in some women. Careful assessment of pelvic pain with a reasonable diagnosis and comprehensive treatment program is the first step toward relief and return to function.

Studies Show:

  • Nearly 15% of women aged 15-50 in the U.S. suffer from chronic pelvic pain
  • 10% of all visits to gynecologists are for pelvic pain
  • About 50% of women with chronic pelvic pain feel depressed and less active.
  • Over 60% of women with chronic pelvic pain have not been provided a specific diagnosis

What you should know:

  • The pelvic floor muscles act as a muscular sling that supports the pelvic organs and openings of the vagina and sphincters and can be injured or weakened causing pain
  • Chronic pain can continue long after tissue injury has healed, and is often due to nerve and muscle problems.
  • Musculoskeletal alignment problems with the pelvic bones including the sacrum and pubic bone can cause pelvic pain
  • Gynecological conditions (endometriosis, ovarian cysts), urological conditions (urinary tract infections, interstitial cystitis) and colorectal conditions (polyps or colon cancer) should be considered as sources of pelvic pain and should be assessed as possible causes
  • Chronic constipation or diarrhea can lead to pelvic floor dysfunction and pelvic pain can become very debilitating

What you can do:

  • NCCRM’s physicians can evaluate you for pelvic nerve problems and/or pelvic floor muscle dysfunction from injury, previous surgery, labor and delivery related conditions, and other chronic pain states
  • Treatment prescriptions may include:
    • Ice and heat
    • Physical therapy by an expert in pelvic floor therapy
    • Education to isolate, recruit and strengthen the supportive pelvic musculature with an appropriate exercise program
    • Electrical stimulation to assist with strengthening when moderate to severe weakness is present
    • Biofeedback to assist with relaxing painful, hyperactive muscles
    • Pain medications and injections to treat inflammation, muscle spasms and nerve pain

Patient Testimonial:
“Since I was 14 years old, I have had severe pain in my pelvic area. The first doctor I saw put me through test after test, finally reaching the decision that the pain was caused by an ovarian cyst and that I needed to have surgery immediately. My father called Dr. Toma that same week to ask him for his expert opinion.  Dr. Toma instantly suggested I had another MRI and told us to wait for those results before doing anything. We received the results the day before I was scheduled for surgery, Dr. Toma told us that I did not need to have surgery to remove the cyst and most definitely did not need to have my ovary removed.
Then when I was 19 year old, after seeing two different doctors and trying various medicines to control the pain, my doctor told me I had endometriosis. He said in order for me to have the pelvic pain completely go away, I would need to have surgery. Once again we called Dr. Toma to see what he thought.  After filling him in, Dr. Toma immediately scheduled an appointment to see me that same week. In that appointment Dr. Toma told us what no other doctor had told me before. He said, “We are going to try every option possible before surgery; surgery is a last result for any patient, but especially for someone as young as you. We are not even close to needing surgery.”
From that day forward Dr. Toma has been my one and only doctor.  He has followed through on everything he told me that day. I have been on the same medicine for almost two years and it has completely eliminated the pain I was having daily. He has not only saved me from having potentially life changing surgeries twice and he was able to find a solution that works for me. Another reason Dr. Toma is that best in his field is because of how much he truly cares for each of his patients.”
Mary L.

My experience with the TP4W staff has been top of the line.  They helped me through three pregnancies and coached me through every step of the way.  Eternally thankful I chose TP4W.  – Britney

TP4W have such amazing doctors, midwives and nurses.  I cannot say enough about Dr. Grana and the rest of the staff for all the help, advice, guidance and medical care they provided me with all of my kids.  She made me feel safe and calm through both c-sections.  My routine care and pregnancy care have always been top notch and I would recommend them to anyone looking for an OBGYN.  – Brooke

We were honored to receive a hand written note..

Dr. Grana, Angie, Jessica, Heather, April, Sarah and the rest of the staff –

Thank you all so much for taking such good care of me through both of my pregnancies and births, especially my latest one on 10/29! most of yall know how nervous I was from having gone through a lot (to say the least) with my first in 2016. You all made me feel so comfortable and at ease before, during and after. And going through a touch year with my dad, you guys always asked how he was doing at every appointment, which was so thoughtful and beyond your job description. I know that you all see many women go through what i did each and every day and deliver many babies and perform many c-sections. But I hope you know how special Ruby’s delivery was to me. You all have amazing jobs! I cannot thank you all enough. Merry Christmas!

Love, Lucy

I have been going to TP4W since 2010/11 and could not be happier.

The staff, nurses, midwives, and doctors are all amazing. I have 2 sons, both delivered via cesarean by Dr. V. Every visit and every provider did everything in their power to give me the birth experience I wanted, and also ensure that myself and my babies were safe and healthy. Dr. V even did everything in his power to help me avoid my first c-section and VBAC with the second, but that turned out to be out of his hands and he was the absolute best surgeon. With my two pregnancies, I experienced a few scares and some unusual circumstances that would be too long and too private to write in a review, but every single hurdle was handled with grace, honesty, and professionalism. I am so thankful for the recommendation from a friend to come to this office. I can’t imagine ever going to another practice.

TP4W is amazing and I am so very thankful I found them 9 years ago!! Amazing partnership between midwives and doctors, sweet nurses and front end staff, and relaxing environment. I literally recommend them to all my friends! I look forward to my appointments and feel like I’m going to catch up with old friends.

I’ve always had wonderful experiences at TP4W. Everyone is friendly, knowledgeable, and thorough in their care. April delivered my son and I can’t say enough wonderful things about her. She is patient and compassionate. I had the best labor and delivery experience thanks to her. I do and will continue to recommend them to my friends and family!

TP4W is amazing and I am so very thankful I found them 9 years ago!! Amazing partnership between midwives and doctors, sweet nurses and front end staff, and relaxing environment. I literally recommend them to all my friends! I look forward to my appointments and feel like I’m going to catch up with old friends.

I have been seeing Dr. Grana for just about 4 years now and I must admit that she has been the very best OB I have ever had! She is so personable, friendly, and all around caring about her patients. I’ve never had any issues with the staff, the office is very clean, and if Dr. Grana is running behind, they let me know ahead of time. I highly recommend Dr. Grana and this office to anyone!

I was referred here by my family doctor. I had found out I was pregnant with my first child later last year and had the most difficult time scheduling an appointment at my last OB/GYN Doctor. I was on the verge of tears because I didn’t know what my next steps were and thank goodness I was referred to Triangle Physicians for Women. The service is amazing every appointment I’ve had and they are so organized and have made me feel so comfortable. I have to thank them for making this pregnancy so much smoother and less stressful than it would have been had I stayed with my previous doctor. I highly recommend this place!