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Pelvic Pain

Pelvic pain afflicts millions of men and women every year. It affects patients quality of life and their ability to maintain a job, as it can lead to considerable suffering. Chronic pelvic pain, whether due to cancer or not, can be very difficult to treat and interventions (such as injections or stimulator placements) can be critical to improve pain levels and quality of life.

In some people, there is a problem that can be solved with surgery, but many times the pain has a much more complex treatment including pelvic physical therapy, psychotherapy, medication management, injection therapy, or neuromodulation.

At Interventional Spine of Vermont, we evaluate your pelvic pain and use evidence based medicine as well as alternative approaches to design a comprehensive, personalized treatment plan. This can include referrals, medication recommendations, lifestyle advice, and procedures.

Procedures for pelvic pain relief offered at Interventional Spine of Vermont:

Sacrococcygeal ligament Injection

This is an injection done under x-ray to treat pelvic pain. It is usually the first line of treatment for pain coming from the peritoneum and the genital area. Pain coming from the cervix, bladder, endometrium, and rectum all can benefit from this injection. The injection involves depositing steroid medicine at the level of the sacrum under fluoroscopic (X-ray) guidance.

Ganglion Impar Injection

This is an injection done under x-ray to treat pelvic pain. It is usually the first line of treatment for pain coming from the peritoneum and the genital area. Pain coming from the cervix, bladder, endometrium, and rectum all can benefit from this injection. The injection involves depositing steroid medicine at the level of the sacrum under fluoroscopic (X-ray) guidance.

Inferior Hypogastric Injection

This is an injection done under x-ray to treat pelvic pain. It is particularly helpful to treat pain which comes from the gastrointestinal tract, the uterus, bladder, penile pain, prostate pain, rectal pain, anal pain, sacral pain, post-radiation pelvic pain, and postherpetic neuralgia of the sacral area. This injection is usually done with mild sedation, in which case you will be asked not to eat or drink anything the day of the procedure (exception: you can have clear fluids up to 2 hours prior to the injection).

If effective, relief could either be immediate or gradual, peaking at 2-3 weeks (and this is due to the complicated nature of pelvic pain, in which many neurons are involved).

Pudendal Nerve Block

The pudendal nerve transmits pain coming from the uterus, the labia, the vagina, the perineum, and the skin in this area. A block of this nerve is done under x-day and can be helpful in interrupting the production of pain neurotransmitters, as well as decreasing inflammation. Pain relief from a pudendal nerve block may last from weeks to months, depending on the patient. Sometimes, a patient may need a series of injections (2 or 3) to bring the pain down to a manageable level. After this series, injections if needed are every 4 months or more.

Spinal Cord Stimulation

Spinal cord stimulation is a medication-free treatment of painful conditions including pelvic pain. The pain treatment is based on interruption of signals that transmit pain. Although the entirety of the science of why this treatment works is not understood, there are many studies proving that this treatment is helpful in relieving pain and improving the life of many, many patients.

Spinal cord stimulation involves insertion of a small device under your skin (usually the buttocks) which is connected to a thin wire that is placed along your spinal column. This is done in the operating room with anesthesia. Prior to this permanent placement, you will have a trial at our clinic where the thin wires are placed percutaneously, and attached to a stimulator that rests on your skin, secured with a dressing. to Our board-certified physicians, Dr. Ivie and Dr. Caballero, can help you decide whether this is a good option for you and explain the process in detail.

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Peripheral Nerve Stimulator

It is a medication-free treatment of painful conditions including pelvic pain. Rather than going in your spine, such as the spinal cord stimulator, this treatment targets the nerve or nerves that cause most of the pain. The pain treatment is based on interruption of signals that transmit pain. Although the entirety of the science of why this treatment works is not understood, there are many studies proving that this treatment is helpful in relieving pain and improving the life of many, many patients.

Peripheral nerve stimulation involves attachment of a small device which is connected to a thin wire that is placed along the nerve/s that is causing you most of the pain. This is done in the operating room with anesthesia. Prior to this permanent placement, you will have a trial at our clinic where the thin wires are placed percutaneously, and attached to a stimulator that rests on your skin. Our board-certified physicians, Dr. Ivie and Dr. Caballero, can help you decide whether peripheral nerve stimulation is a good choice for you.