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Condition/Disorder Synonyms

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  • Chronic pelvic pain syndrome

  • Levator ani syndrome

  • Urogential pain disorders

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ICD-9-CM Codes

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  • 338.4 Chronic pain syndrome

  • Associated medical diagnoses

    • 564.6 Anal spasm

    • 569.42 Anal or rectal pain

    • 595.1 Chronic interstitial cystitis

    • 601.1 Chronic prostatitis

    • 617 Endometriosis

    • 625.0 Dyspareunia

    • 625.5 Pelvic congestion syndrome

    • 625.7 Vulvodynia

    • 625.71 Vulvar vestibulitis

  • Associated Physical Therapy Diagnoses

    • 719.45 Pain in joint, pelvic region and thigh

    • 724.7 Disorders of coccyx

    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified

    • 728.85 Spasm of muscle

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.1 Myalgia and myositis, unspecified

    • 729.2 Neuralgia, neuritis, and radiculitis, unspecified

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 782.3 Edema

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ICD-10-CM Codes

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  • G89.4 Chronic pain syndrome

  • N30.10 Interstitial cystitis (chronic) without hematuria

  • N30.11 Interstitial cystitis (chronic) with hematuria

  • N41.1 Chronic prostatitis

  • N80 Endometriosis

  • R10.2 Pelvic and perineal pain

  • Symptom specific diagnoses

    • K59.4 Anal spasm

    • N53.12 Painful ejaculation

    • N94.1 Dyspareunia

    • N94.81 Vulvodynia

    • N94.810 Vulvar vestibulitis

    • N94.818 Other vulvodynia

    • N94.819 Vulvodynia unspecified

    • N94.89 Other condition associated with female genital organs and menstrual cycle

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Preferred Practice Pattern

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Key Features

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Description2

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  • Defined by a process of exclusion

  • Non-specific, poorly localized pelvic pain or regional pelvic pain syndrome without obvious pathology

  • No evidence of infection or inflammation

  • Chronic urogential pain syndromes often associated with end organ pain conditions (such as bladder, vulva) and psychological conditions (such as emotional, sexual, behavioral)

  • Genitourinary pain syndromes are all chronic in their nature

  • Pain is the major complaint but concomitant complaints include lower urinary tract, bowels, or are sometimes sexual or gynecological in nature3

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Essentials of Diagnosis

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  • Unknown etiology

  • Rule out end organ pathology

  • Symptoms may be initiated by an acute infection, injury, or inflammation of a pelvic or urogential organ, however pain persists beyond the duration of the original inciting event or disease

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General Considerations

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  • Chronic pain condition

  • Often misdiagnosed

  • PT intervention is often appropriate for associated musculoskeletal impairments

  • Diagnosis is a process of exclusion and often takes time, requiring intensive diagnostic testing

  • Urogenital pain disorders frequently affect nearby body areas; especially back, pelvic, hip, and groin regions and so may be inappropriately referred to PT

  • May mimic other visceral pain conditions including colon cancer or tumors, irritable bowels, colitis

  • May mimic gynecologic problems in females: endometriosis, uterine fibroids, ectopic pregnancy

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Demographics

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  • More prevalent in females

  • Exact prevalence of chronic pelvic pain is not known, estimates ...

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