Frequency and Distribution of Multiple Diagnoses in Chronic Pelvic Pain Related to Previous Abuse or Drug-Seeking Behavior

Background: The objective of this study was to describe the nature and number of pain diagnoses in a chronic pelvic pain population, and to determine the relationship between these and a patient’s history of abuse, drug-seeking behavior, or initial symptom scores. Methods: 175 consecutive patients were evaluated at the Summa Chronic Pelvic Pain Center and assigned diagnoses. These diagnoses included gynecologic pain, interstitial cystitis (IC), irritable bowel syndrome (IBS), pelvic floor tension myalgia, abdominal wall myalgia, and vulvodynia. The diagnosis of drug seeking was based upon a patient’s refusal of non-narcotic management. Results: Multiple diagnoses were common, occurring in 58% of all patients, and in up to 96% of those diagnosed with non-gynecologic pain. A history of abuse was present in 55% of all patients. Drug seeking was diagnosed in 13% of all patients. Significantly elevated IC, IBS, and myalgia scores were associated with previous abuse and multiple pain diagnoses. Conclusion: Patients with chronic pelvic pain frequently have multiple pain diagnoses, and non-gynecologic pain in particular is common. Multiple pain diagnoses and a history of abuse have similar symptom patterns, suggesting a relationship which can be used to distinguish these patients from those with drug-seeking behavior.