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Differential Diagnostics of Chronic Pelvic Pain

Herman & Wallace Pelvic Rehabilitation Institute

Objectives

Upon completion of this continuing education seminar, participants will be able to:
1. Demonstrate palpation, examination, and interventions for the thoracic, lumbar, and sacral spine as related to pelvic pain
2. Describe the structures of the bony pelvis and acetabular structures as related to pelvic pain
3. Describe the interaction of the central and peripheral nervous systems and the potential impact on chronic pelvic pain
4. Explain the psychology of pain, and how it can relate to a magnification and persistence of pelvic pain
5. Describe how fascia becomes “tight” and how to release fascia
6. Describe the role of and potential dysfunction caused by scar tissue in pelvic pain
7. Demonstrate internal (vaginal) muscle and anatomical landmark palpation
8. Explain the value of differential diagnosis in identifying structures at fault in chronic pelvic pain presentations.

Target Audience

This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.

Confirmation Notes

What to bring: Mobilization belt, Yoga mat, Foam roller, Reflex hammer

Agenda

Day One:

4:00 Registration 4:30 Pre-Test 5:00 Introduction 5:30 Pelvic Osseus Lecture 6:00 Pelvic Palpation Laboratory 7:30 Vertebral Anatomy Lecture 8:00 Vertebral Palpation Laboratory 9:00 Adjourn

Day Two:

8:00 Neuroanatomy of Pelvic Pain 9:30 Visceral Embryology 10:00 Break 10:10 Pain Lecture 11:40 Evaluation Lecture- spine 12:15 LUNCH 1:15 Evaluation Laboratory- spine 2:45 Break 2:55 Evaluation Lecture- perineum 3:30 Evaluation Laboratory- perineum 5:00 Adjourn

Day Three:

8:00 Connective Tissue Lecture 9:00 Differential Palpation Pelvic Structures 10:00 Interpretation 10:30 Treatment - Mobilization Lecture 11:00 Treatment - Mobilization Laboratory 12:00 Lunch 1:00 Treatment - Connective Tissue Laboratory 2:30 Treatment & Supportive Exercises 3:00 Treatment & Supportive Laboratory 5:00 Adjourn

Description

According to Hoppenfeld in his text on Physical Examination of the Spine & Extremities, accurate diagnosis depends on knowledge of functional anatomy, diligent observation, and a thorough examination. For the patient who presents with chronic pelvic pain, it is common to report pain and dysfunction in multiple body segments such as the spine, pelvis and hips. This continuing education course prepares the participant to apply differential diagnostic skills for chronic pelvic pain, allowing for more accurate intervention strategies that are directed to specific tissues.

Through multiple anatomy lectures and detailed palpation labs, a therapist's ability to "know exactly where you are" is enhanced through this class. And while knowledge of anatomy and skills in examination are critical in finding the source of a patient's pain, the influence of the nervous system must be considered for its impact on a patient's presentation.The influence of the nervous system on pain is learned in this course through study of the somatic and autonomic nervous system anatomy, function, and relationship to the pelvis. A therapist will learn systematic methods for examination of the joints, muscles, fascia, and nervous system and will be given tools to record findings of specific assessments.

The concepts instructed in this course are designed to be easily integrated into a therapist's current evaluation and intervention strategies. Foundational instruction includes an emphasis on embryology so that referred pain patterns are best understood. Sufficient lab opportunities are provided to allow the participant to practice the material that is demonstrated. Both external and internal pelvic muscle examination and treatment techniques will be included, with an emphasis on specific palpation and testing to allow the clinician to accurately identify sources of dysfunction. The course information is applicable to the patient who presents with pain as a primary complaint, as well as the patient suffering from both surgical and non-surgical voiding disorders.

Special Considerations:
As this continuing education course includes extensive lab work, all course attendees should come prepared to participate as both clinician and patient. Internal (vaginal) pelvic floor muscle examinations will be taught in labs.

Date And Locations
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