Pelvic Pain. Developed for OUCOM CORE by: Anna Wright, D.O. Edited by: Katrina Rakowsky D.O., Imber Coppinger, D.O. and the CORE Osteopathic Principles and Practices Committee. 31 yr old female presents for continued RLQ/inguinal pain
Developed for OUCOM CORE
by: Anna Wright, D.O.
Edited by: Katrina Rakowsky D.O., Imber Coppinger, D.O.
CORE Osteopathic Principles and Practices Committee
Began after right inguinal herniorrhaphy with a difficult, unusually painful recovery
Now continuing after 6 months S/P surgery
Worse with stress or activity
Describes pain as “Deep ache” 3/10 on pain scale. “Pins and needle” sensation superficially.
Better after yoga but becomes worse 30 minutes laterCC: RLQ pain
No changes in menstruation, pain not associated with menses.
Negative trauma history
Otherwise no complaintsPatient History
CBC/ BMP tested and normal.
Urine pregnancy test negativeTest Results
Base of penis and scrotum in men
Labia majora and mons pubis in women
Originates at L1-L2Ilioinguinaland Genitofemoral nervedistributions
Balance fascia to normalize tension on nerves
Improve lymphatic flowGoals of Treatment
Muscle Energy Technique
Kimberly, 2000, p267-269
Spasm of pelvic diaphragm may influence sacral or pelvic function.Pelvic Diaphragm
Moore, Clinically Oriented Anatomy, 4th Edition, 1999, p.400
Speece, 1st edition, p71-73
Greenman, Principles of Manual Medicine, 3rd ed. Lippincott. 2003. pp 338-388
Kimberly, Kimberly Manual, Walsworth, 2000, pp267-269
Moore, Clinically Oriented Anatomy, 4th ed. Williams and Wilkins. 1999. p 400References
Speece, Ligamentous Articular Strain, Eastland. 2001. pp 71-73, 79
Ward, Foundations of Osteopathic Medicine, Lippincott. 2003. p 946-947References