{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T05:53:32Z","timestamp":1768974812381,"version":"3.49.0"},"reference-count":129,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,11,21]],"date-time":"2012-11-21T00:00:00Z","timestamp":1353456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The multisystem nature of female chronic pelvic pain (CPP) makes this condition a challenge for physical therapists and other health care providers to manage. This article uses a case scenario to illustrate commonly reported somatic, visceral, and neurologic symptoms and their associated health and participation impact in a female with CPP. Differential diagnosis of pain generators requires an in\u2010depth understanding of possible anatomic and physiologic contributors to this disorder. This article provides a detailed discussion of the relevant clinical anatomy with specific attention to complex interrelationships between anatomic structures potentially leading to the patient's pain. In addition, it describes the physical therapy management specific to this case, including examination, differential diagnosis, and progression of interventions. Clin. Anat. 26:77\u201388, 2013. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ca.22187","type":"journal-article","created":{"date-parts":[[2012,11,21]],"date-time":"2012-11-21T12:36:14Z","timestamp":1353501374000},"page":"77-88","source":"Crossref","is-referenced-by-count":20,"title":["Physical therapy management of female chronic pelvic pain: Anatomic considerations"],"prefix":"10.1002","volume":"26","author":[{"given":"Susan E.","family":"George","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan C.","family":"Clinton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane F.","family":"Borello\u2010France","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,11,21]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.10052"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-006-0074-3"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.11.076"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2011.00465.x"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-11-200306030-00008"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.1075"},{"key":"e_1_2_3_8_1","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/S0889-8545(21)00389-2","article-title":"Musculoskeletal origins of chronic pelvic pain: Diagnosis and treatment","volume":"20","author":"Baker PK","year":"1993","journal-title":"Obstet Gynecol Clin North Am"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.124844"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/85.3.269"},{"key":"e_1_2_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(99)00485-9"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016345709158023"},{"key":"e_1_2_3_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1999.tb01294.x"},{"key":"e_1_2_3_14_1","first-page":"87","volume-title":"Pelvic floor muscle exercises and behavioral therapy","author":"Burgio KL","year":"2007"},{"key":"e_1_2_3_15_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-103-4-507"},{"key":"e_1_2_3_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.23.1995"},{"key":"e_1_2_3_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.18.2293"},{"key":"e_1_2_3_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2011.01243.x"},{"key":"e_1_2_3_19_1","first-page":"588","article-title":"Obturator internus strain in the hip of an adolescent athlete","volume":"38","author":"Busfield BT","year":"2009","journal-title":"Am J Orthop"},{"key":"e_1_2_3_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-200312000-00011"},{"key":"e_1_2_3_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2009.08.011"},{"key":"e_1_2_3_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0079-6123(08)62763-6"},{"key":"e_1_2_3_23_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.1999.29.2.83"},{"key":"e_1_2_3_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.07.044"},{"key":"e_1_2_3_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmpt.2005.07.012"},{"key":"e_1_2_3_26_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.06.0051"},{"key":"e_1_2_3_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2005.00039.x"},{"key":"e_1_2_3_28_1","first-page":"129","volume-title":"Textbook of Pain","author":"Devor M","year":"1999"},{"key":"e_1_2_3_29_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200407000-00006"},{"key":"e_1_2_3_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00304293"},{"key":"e_1_2_3_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200011150-00017"},{"key":"e_1_2_3_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(01)00349-9"},{"key":"e_1_2_3_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.061515"},{"key":"e_1_2_3_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-003-1049-0"},{"key":"e_1_2_3_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.04.022"},{"key":"e_1_2_3_36_1","first-page":"477","article-title":"The Fortin finger test: An indicator of sacroiliac pain","volume":"26","author":"Fortin JD","year":"1997","journal-title":"Am J Orthop"},{"key":"e_1_2_3_37_1","first-page":"687","article-title":"Sacroiliac joint innervation and pain","volume":"28","author":"Fortin JD","year":"1999","journal-title":"Am J Orthop"},{"key":"e_1_2_3_38_1","first-page":"249","volume-title":"Evidenced\u2010Based Physical Therapy for the Pelvic Floor: Bridging Science and Clinical Practice","author":"Frawley H","year":"2007"},{"key":"e_1_2_3_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2005.01.353"},{"key":"e_1_2_3_40_1","first-page":"959","article-title":"Electromyographic comparisons of the pelvic floor in women with dysesthetic vulvodynia and asymptomatic women","volume":"43","author":"Glazer HI","year":"1999","journal-title":"J Reprod Med"},{"key":"e_1_2_3_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-007-0395-8"},{"key":"e_1_2_3_42_1","first-page":"117","article-title":"Innervation of the sacroiliac joint of the human","volume":"54","author":"Grob KR","year":"1995","journal-title":"Z Rheumatol"},{"key":"e_1_2_3_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.OGX.0000083225.90017.01"},{"key":"e_1_2_3_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-008-0435-1"},{"key":"e_1_2_3_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.03.064"},{"key":"e_1_2_3_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(03)00365-4"},{"key":"e_1_2_3_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/JWH.0b013e31823b0750"},{"key":"e_1_2_3_48_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.2000.89.3.967"},{"key":"e_1_2_3_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00005644"},{"key":"e_1_2_3_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-199802000-00008"},{"key":"e_1_2_3_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(99)00216-5"},{"key":"e_1_2_3_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.09.026"},{"key":"e_1_2_3_53_1","first-page":"145","article-title":"The painful coccyx","volume":"14","author":"Howorth B","year":"1959","journal-title":"Clin Orthop"},{"key":"e_1_2_3_54_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000076821.41875.1C"},{"key":"e_1_2_3_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/0268-0033(95)00003-4"},{"key":"e_1_2_3_56_1","doi-asserted-by":"publisher","DOI":"10.1179\/108331905X55776"},{"key":"e_1_2_3_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000128906.61529.6b"},{"key":"e_1_2_3_58_1","first-page":"334","article-title":"Pelvic floor physical therapy in urogynecologic disorders","volume":"3","author":"Kotarinos RK","year":"2003","journal-title":"Curr Womens Health Rep"},{"key":"e_1_2_3_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-012-0277-8"},{"key":"e_1_2_3_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0004-9514(14)60125-2"},{"key":"e_1_2_3_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2005.01.003"},{"key":"e_1_2_3_62_1","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1093\/ptj\/79.11.1043","article-title":"Four clinical tests of sacroiliac joint dysfunction: The association of test results with innominate torsion among patients with and without low back pain","volume":"79","author":"Levangie P","year":"1999","journal-title":"Phys Ther"},{"key":"e_1_2_3_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00007097"},{"key":"e_1_2_3_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2010.07.008"},{"key":"e_1_2_3_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(95)00458-0"},{"key":"e_1_2_3_66_1","series-title":"Bonica's Management of Pain","first-page":"1388","author":"McDonald JS","year":"2001"},{"key":"e_1_2_3_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-4754(99)70098-9"},{"key":"e_1_2_3_68_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005860050206"},{"key":"e_1_2_3_69_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2005.01.016"},{"key":"e_1_2_3_70_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2007.01530.x"},{"key":"e_1_2_3_71_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-10-82"},{"key":"e_1_2_3_72_1","volume-title":"Clinically Oriented Anatomy","author":"Moore KL","year":"2006"},{"key":"e_1_2_3_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-0266(00)90017-2"},{"key":"e_1_2_3_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2009.01.004"},{"key":"e_1_2_3_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2009.12.001"},{"key":"e_1_2_3_76_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200201010-00015"},{"key":"e_1_2_3_77_1","first-page":"1535","article-title":"Chronic pelvic pain in women","volume":"77","author":"Ortiz DD","year":"2008","journal-title":"Am Fam Phys"},{"key":"e_1_2_3_78_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-36374-5_3"},{"key":"e_1_2_3_79_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02616644"},{"key":"e_1_2_3_80_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2012.01404.x"},{"key":"e_1_2_3_81_1","doi-asserted-by":"publisher","DOI":"10.1586\/17474108.2.1.37"},{"key":"e_1_2_3_82_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-006-0053-6"},{"key":"e_1_2_3_83_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2007.01520.x"},{"key":"e_1_2_3_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0004-9514(14)60100-8"},{"key":"e_1_2_3_85_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.03.008"},{"key":"e_1_2_3_86_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.21053"},{"key":"e_1_2_3_87_1","doi-asserted-by":"publisher","DOI":"10.1054\/math.1998.0311"},{"key":"e_1_2_3_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(02)00179-1"},{"key":"e_1_2_3_89_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2004.02.008"},{"key":"e_1_2_3_90_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20421"},{"key":"e_1_2_3_91_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2007.06.004"},{"key":"e_1_2_3_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8553(05)70169-2"},{"key":"e_1_2_3_93_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02053604"},{"key":"e_1_2_3_94_1","first-page":"253","article-title":"Nongynecologic somatic pathology in women with chronic pelvic pain and negative laparoscopy","volume":"36","author":"Reiter RC","year":"1991","journal-title":"J Reprod Med"},{"key":"e_1_2_3_95_1","first-page":"2","article-title":"Urinary incontinence in women","volume":"47","author":"Retzky SS","year":"1995","journal-title":"Clin Symp"},{"key":"e_1_2_3_96_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200202150-00015"},{"key":"e_1_2_3_97_1","first-page":"31","volume-title":"Chronic Pelvic Pain: An Integrated Approach","author":"Rogers RM","year":"1988"},{"key":"e_1_2_3_98_1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.3928\/0147-7447-20030401-23","article-title":"Obturator internus tendinitis as a source of chronic hip pain","volume":"26","author":"Rohde RS","year":"2003","journal-title":"Orthopedics"},{"key":"e_1_2_3_99_1","doi-asserted-by":"publisher","DOI":"10.1080\/009262300278597"},{"key":"e_1_2_3_100_1","first-page":"138","volume-title":"Diagnosis and Treatment of Movement Impairment Syndromes","author":"Sahrmann SA","year":"2002"},{"key":"e_1_2_3_101_1","doi-asserted-by":"publisher","DOI":"10.1002\/1520-6777(2001)20:1<31::AID-NAU5>3.0.CO;2-P"},{"key":"e_1_2_3_102_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2008.01.029"},{"key":"e_1_2_3_103_1","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1007\/s00345-002-0309-9","article-title":"Overactive bladder inhibition in responseto pelvic floor muscle exercises","volume":"20","author":"Shafik A","year":"2003","journal-title":"World J Urol"},{"key":"e_1_2_3_104_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1024180319005"},{"key":"e_1_2_3_105_1","first-page":"245","article-title":"Biomechanical simulation of the anteroposterior compression injury of the pelvis. An understanding of instability and fixation","volume":"309","author":"Simonian PT","year":"1994","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_3_106_1","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.1983.11697758"},{"key":"e_1_2_3_107_1","first-page":"289","volume-title":"Last's Anatomy Regional and Applied","author":"Sinnatamby CS","year":"2011"},{"key":"e_1_2_3_108_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(00)90080-7"},{"key":"e_1_2_3_109_1","doi-asserted-by":"publisher","DOI":"10.1016\/0268-0033(93)90002-Y"},{"key":"e_1_2_3_110_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B9.23893"},{"key":"e_1_2_3_111_1","doi-asserted-by":"publisher","DOI":"10.1249\/00149619-200210000-00007"},{"key":"e_1_2_3_112_1","first-page":"724","volume-title":"Gray's Anatomy: The Anatomical Basis of Clinical Practice","author":"Standring S","year":"2008"},{"key":"e_1_2_3_113_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-008-0092-x"},{"key":"e_1_2_3_114_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198902000-00004"},{"key":"e_1_2_3_115_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.09.002"},{"key":"e_1_2_3_116_1","series-title":"Myofascial Pain and Dysfunction: The Trigger Point Manual: The Lower Extremities","first-page":"110","author":"Travell JC","year":"2003"},{"key":"e_1_2_3_117_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20817"},{"key":"e_1_2_3_118_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-007-9140-0"},{"key":"e_1_2_3_119_1","doi-asserted-by":"publisher","DOI":"10.1155\/2002\/493463"},{"key":"e_1_2_3_120_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199603010-00005"},{"key":"e_1_2_3_121_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-200403000-00004"},{"key":"e_1_2_3_122_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)65539-5"},{"key":"e_1_2_3_123_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198011000-00014"},{"key":"e_1_2_3_124_1","first-page":"324","volume-title":"Gray's Anatomy","author":"Williams PL","year":"1989"},{"key":"e_1_2_3_125_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-006-0169-x"},{"key":"e_1_2_3_126_1","first-page":"135","volume-title":"A Headache in the Pelvis: A New Understanding and Treatment for Chronic Pelvic Pain Syndromes","author":"Wise D","year":"2008"},{"issue":"3","key":"e_1_2_3_127_1","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.pain.2010.09.030","article-title":"Central sensitization: Implications for the diagnosis and treatment of pain","volume":"152","author":"Woolf CJ","year":"2010","journal-title":"Pain"},{"key":"e_1_2_3_128_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.21216"},{"key":"e_1_2_3_129_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1529-9430(03)00151-7"},{"key":"e_1_2_3_130_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ajp.0000131413.07468.8e"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fca.22187","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.22187","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T01:23:38Z","timestamp":1694481818000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.22187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,11,21]]},"references-count":129,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1002\/ca.22187"],"URL":"https:\/\/doi.org\/10.1002\/ca.22187","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"value":"0897-3806","type":"print"},{"value":"1098-2353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11,21]]}}}