In her position a Lead of Pelvic Pain services at Solihull hospital, Dr. Tewani is highly experienced at treating torso-related pain issues, utilising holistic approaches beyond just medications, injections & referrals – she helps patients improve their lifestyles and health which has a long term impact on reducing pain.
She writes, “Abdominal and pelvic pain is as common as back pain but services to provide relief from this difficult problem are not well established. Most often these patients are left to suffer in silence and either feel too embarrassed to look for help or do not know where to look for it.”
She offers a comprehensive service to help diagnose and treat torso-related pain.
Types of pain
Chest wall
The chest wall refers to the structures surrounding and protecting your lungs, including your ribs and sternum. Chest wall pain can come from your breast, rib cage, or a muscle in your chest.
You may get pain only with certain movements or if pressure is applied to your chest wall. It may be felt on one or both sides. A heart attack can cause chest wall pain, but more commonly, chest wall pain is caused by other conditions, including muscle, lung, or digestive issues. The pain can come from arthritis of the junction of the ribs with the breastbone. It may be due to stress fractures of the ribs, slipping rib syndromes, nerve entrapment or fibromyalgia, or due to rheumatic conditions.
Abdominal & pelvic
Abdominal pain is pain below your bellybutton and between your hips. The pain can arise from the abdominal wall muscles, nerves or the organs that lie within such as the gallbladder, pancreas, kidneys, stomach, intestines, or the appendix. Chronic abdominal or pelvic pain is pain that lasts three months or longer.
Certain conditions causing chronic pelvic pain are endometriosis, musculoskeletal problems, fibromyalgia, pelvic floor muscle tension, inflammation of the pubic joint (pubic symphysis) or hernia. Some doctors believe enlarged, varicose-type veins around your uterus and ovaries may result in pelvic pain. However, other doctors are much less certain that pelvic congestion syndrome is a cause of pelvic pain because most women with enlarged veins in the pelvis have no associated pain. Depression, chronic stress, or a history of sexual or physical abuse may increase your risk of chronic pelvic pain. Emotional distress makes pain worse, and living with chronic pain contributes to emotional distress. These two factors often become a vicious cycle.
Treatment
Your symptoms will help Dr. Tewani discern the cause of your pain. You may have to undergo clinical examination, which will help her reach a diagnosis to provide the appropriate treatment. Sometimes, investigations or diagnostic injections may be needed to aid the diagnosis.
To reduce your pain, you may be prescribed medications or be given suitable lifestyle advice. If the treatment for your underlying condition is outside the remit of the clinic, she will refer you to an appropriate specialist, including physiotherapists, psychologists, spine surgeons, rheumatologists or others.
Afterwards, if necessary Dr. Tewani will follow up to ensure the correct diagnosis was made and that you have progressed with your treatment.
Injections offered for
Chest wall pain
- Pectoralis major and minor blocks
- Latissimus dorsi block
- Costochondral junction injections
- Facet joint injections
Abdomino-pelvic pain
- TAP blocks
- Anteriror Cutaneous Entrapment syndrome blocks
- Quadratus Lumborum block
- Sacroiliac joint injections
- Pubic symphysis injections
- Pudendal nerve blocks
- Pudendal nerve pulsed radiofrequency denervation