Pelvic Pain – The sacrum, ilium, ischium, pubic symphysis, and coccyx are joined to create the pelvis.  When there is pain in one area of the pelvis, the pain can be felt in other areas. X-rays are important in determining where the damage is located.

Do you have difficulty sitting on both of your glutes? Do you find yourself sitting on one glute uncomfortably? Many traumatic events can cause pelvic pain. For example, being t-boned by another motor vehicle, falling off a bicycle, being in a bicycle collision, or having an accidental fall. After recovery from the accident, did you have instant pain in your groin or hip upon standing? Did you experience pain in the genitalia area? Do you have difficulty sitting on hard surfaces or standing for a long period of time? Do you have pain in your upper glutes when you walk? If you are experiencing any of these sensations, I advise you to follow up with your primary care physician (PCP) or general practitioner (GP) for a pelvic X-ray to rule out any fractures and sacroiliitis. Sacroiliitis is inflammation in one or both sacroiliac joints. It is best treated with a sacroiliac joint injection that is performed under fluoroscopy by a pain management specialist. If fractures are present, your PCP or GP will refer you to an orthopedic specialist. Until the appointment date, I recommend that you do not put any weight on the injured side. Crutches, a walker (toe-touch only), or wheelchair may be needed. NSAIDs and ice packs can be used as needed.

Pelvic Pain

If you experience neuropathic pain in your groin (possible Pudendal Nerve compression) or have uncontrolled fecal and urine incontinence, you will need to follow up with you PCP or GP for a pelvic CT or MRI to assess damaged nerves. Damaged nerves in the sacral spinal cord will affect the bladder and bowels. If you are having urine incontinence, I recommend that you seek a referral to a urologist. For people who have fecal incontinence, a referral to a gastroenterologist (specialist in diseases of the digestive system) and proctologist (specialist in conditions of the rectum and anus) are needed. In the meantime, while you are waiting for your consultations, I highly recommend bladder and bowel retraining. In order to regain control, it’s important to make it a habit of going to the bathroom every two hours whether you need to or not. Bladder retraining technique is effective. It has been significant in helping stroke patients and patients who suffer from overactive bladder to retrain their bowel and bladder.

References:

Sudoł-Szopińska, I., Kwiatkowska, B., Włodkowska-Korytkowska, M., Matuszewska, G., & Grochowska, E. (2015). Diagnostics of Sacroiliitis According to ASAS Criteria: A Comparative Evaluation of Conventional Radiographs and MRI in Patients with a Clinical Suspicion of Spondyloarthropathy. Preliminary Results. Polish journal of radiology, 80, 266–276. doi:10.12659/PJR.892529

Alila Medical Media. (2019). Diagram of the pelvic girdle labeled. [Illustration].