Foundations of Interventional Pain Treatment in Women

Abstract Chronic pelvic pain refers to persistent pain in the pelvic region. It is a complex and challenging disease process to diagnose and treat that is generally multifactorial. Comprehensive and multimodal approaches are the mainstay for treatment and may include physical therapy, medications, injections, neuromodulation, surgical treatments, dietary strategies, alternative treatments, pain psychology, and mind–body interventions. Interventional techniques are commonly used for diagnosing and treating refractory pelvic pain. Diagnostic injections with local anesthetic can help point toward the anatomical cause of pain. However, positive diagnostic injections do not predict the therapeutic efficacy or longer-term relief by adding additional medications such as an injection of steroid, botulinum toxin, platelet-rich plasma, dextrose, local anesthetics, or alcohol. Implantable peripheral or spinal neuromodulation strategies modulate the processing of pain signals by the central and peripheral nervous system.