1. Psychosocial

2.  Often ill defined, and its anatomic distribution depends more on the person's concepts than on clinical disease processes. Pelvic pain may co-evolve with relational dysfunction, such pain does not usually radiate; commonly, the client has multiple unrelated symptoms, and fluctuations in the course of symptoms are determined more by crises in the person's psychosocial life than by physical changes.

3. Causes  Anxiety  Depression  Panic disorder  Muscle tension  More anxiety  Muscle spasm

4. Signs and Symptoms  A history of sexual abuse in childhood or adulthood (men and women) may contribute to chronic pelvic pain or symptoms of a vague and diffuse nature. In some cases, the link between abuse and pelvic pain may be psychologic or neurologic, or may result from biophysical changes that heighten a person's physical sensitivity to pain. Taking a history of sexual abuse may be warranted. Occasionally, a woman has been told there is no organic cause for her distressing pelvic pain. Chronic vascular pelvic congestion, enhanced by physical or emotional stress, may be the underlying problem.

5. PT Implications  The therapist may be instrumental in assessing for this condition and providing some additional clues to the medical community that can lead to a medical diagnosis.

6. Reference  Goodman, Catherine Cavallaro and Snyder, Teresa E. Kelly. Differential Diagnosis for Physical Therapists: Screening for Referral. 2007 ed. Vol. 4th Edition. St. Louis, Missouri: Saunders Elsevier, 2007. Print.