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1/3. A systematic history for the patient with chronic pelvic pain.

    Chronic pelvic pain is a source of frustration to both the physician and the patient. physicians have been ill equipped by their training to confront the multifaceted nature of the complaints of patients with chronic pelvic pain. patients have experienced a repetitive dismissal of their complaints by physicians too busy in their practices to address their problems comprehensively. The approach to the patient with chronic pelvic pain must take into account six major sources of the origin of this pain: 1) gynecological, 2) psychological, 3) myofascial, 4) musculoskeletal, 5) urological, and 6) gastrointestinal. Only by addressing and evaluating each of these components by a very careful history and physical examination and by approaching the patient in a comprehensive manner can the source of the pain be determined and appropriate therapy be administered. This article was developed to provide the clinician with a set of tools and a methodology by which the patient with this complaint can be approached.
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ranking = 1
keywords = physical
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2/3. pelvic floor physical therapy in urogynecologic disorders.

    physical therapists are uniquely qualified to treat pelvic floor dysfunction with conservative management techniques. Techniques associated with incontinence and support functions of the pelvic floor include bladder training and pelvic floor rehabilitation: pelvic floor exercises, biofeedback therapy, and pelvic floor electrical stimulation. Pain associated with mechanical pelvic floor dysfunction can be treated by physical therapists utilizing various manual techniques and modalities. research documents that conservative management is effective in treating many conditions associated with pelvic floor dysfunction. research should be conducted to determine if addressing diastasis recti and contracture of the pelvic floor musculature should be a component of the standard physical therapy protocol.
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ranking = 6
keywords = physical
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3/3. Nongynecologic causes of unexplained lower abdominal pain in adolescent girls.

    Unexplained lower abdominal pain in young women can present a challenge for even the most experienced clinicians. Although the cause is usually benign and self-limited, occasionally a serious underlying disorder exists. Clinicians should have an organized approach for diagnosis and management in an effort to avoid any unnecessary tests or referrals. The most important elements of the evaluation are thorough history, careful physical, and sequential follow-up as needed. Selective use of the laboratory and radiographic studies should be considered on an individual basis. This paper describes four disorders in adolescent girls that may present with pain in the lower abdominal region and closely resemble pathologic conditions within the gynecologic tract. Practitioners who provide services to young women should be aware of these entities so that the correct diagnosis is established as soon as possible and appropriate therapy initiated in a timely fashion.
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ranking = 1
keywords = physical
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