Acute or chronic pelvic pain is often due to musculoskeletal disorders, which may go unrecognized during a traditional pelvic examination. Proper evaluation facilitates the diagnosis of spasm or trigger points, and physical therapy often achieves a major improvement in quality of life for these women.
http://www.modernmedicine.com/modernmed ... ryId=40157
SUMMARY
Even experienced practitioners may misdiagnose patients with pelvic pain if they do not specifically examine the pelvic diaphragm. Attention to the pelvic floor musculature during pelvic examinations is an effective and inexpensive diagnostic strategy that can be life-changing for patients with pelvic pain, yet requires minimal time and effort. These patients may have to undergo the usual chronic pelvic pain algorithm without the option of physical therapy if hypertonus goes unrecognized.Physical therapy with or without pharmacologic management offers many patients significant relief or even resolution. Educating patients and using physical therapy to make them active partners in their own care give women with chronic pelvic pain a sense of empowerment and benefit them physically and psychologically. Although the inverted single-digit examination of the pelvic floor musculature is well established in the literature, we again emphasize its use as a routine element of the pelvic evaluation. This simple technique may reduce cost and suffering in this patient population with minimal diagnostic effort.