From what I have learned from some doctors and literature is that there would have to be some calcification of the tendons showing on imaging to warrant a problem there being a diagnosis for the cause of (some) pelvic pain.
I have to say that I think this is a little short sighted.
Guidelines to Chronic Pelvic Pain, 2012 (on home page) mentions this;
2.3.3 Muscles and pelvic pain
In the urogenital pain syndromes muscle tenderness and trigger points may be implicated as a source of pain.
Central mechanisms are of great importance in the pathogenesis of this muscle hyperalgesia. The muscles
involved may be a part of the spinal, abdominal or pelvic complex of muscles. It is not unknown for adjacent
muscles of the lower limbs and the thorax to become involved. Pain may be localised to the trigger points
but is more often associated with classical referral patterns.
As well as trigger points, inflammation of the
attachments to the bones (enthesitis) and of the bursa (bursitis) may be found
I would say that this could also happen in relation with spasmed and tight pelvic muscles that can cause pelvic nerve entrapment.
The enthesis is where the muscle attaches the tendon to the bone.
I was told that enthesitis or tendonosis can occur as people age anyway, maybe especially if people are fairly active? I suppose it will depend on how much of a problem is reported on imaging and if that can match with a patients current pain and history.
I think that the problem would probably need to be assessed by a physiotherapist as Violet mentioned.
You have raised other valid points too Karyn.
Did you realise that recent European guidelines as to where the lower back ends is 'to the gluteal fold'. So medical notes can mention low back pain but it was not what you or I (or most people) would describe as low back. It could be sacroiliac or anywhere in the pelvis by that definition, although agreed the hip is a separate speciality. So is urogynae section but it can get very confusing if not just plain WRONG sometimes. Thank goodness I do know my bum from the rest.
Interestingly our NHS (NICE) guidelines also mention ESWT for tendinosis, although not exactly 'recommended' just mentioned.
Unfortunately only in connection with shoulders, heels and arse. . . .sorry elbow
![Laughing :lol:](./images/smilies/icon_lol.gif)
What was I saying?
Your question does highlight the which bit belongs to which medical speciallity. In our case none!
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.