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Review
. 2025 Aug;43(3):577-594.
doi: 10.1016/j.ncl.2025.05.003. Epub 2025 Jun 11.

Pelvic Pain: Tools for the Neurologist

Meheret Mekonnen  1 , Karissa Leong  2 , Elise Jb De  3 , Brennan Wells  4
Affiliations
Review

Pelvic Pain: Tools for the Neurologist

Meheret Mekonnen et al. Neurol Clin. 2025 Aug.

Abstract

Chronic pelvic pain (CPP) presents a diagnostic challenge in which neurologic evaluation often play a central role, especially in cases resistant to standard treatments. Multiple sclerosis, herniated disc, and pudendal neuropathy are commonly associated with pelvic pain, but central sensitization, small fiber neuropathy, and other peripheral neuropathies can frequently contribute to pain persistence and complexity. This review guides neurologists in the evaluation of CPP from an interdisciplinary approach, providing strategies for differential diagnosis, neurodiagnostic testing, and symptom management tailored to the neurologic underpinnings of pelvic pain.

Keywords: COPCs; CPP; Chronic overlapping pain syndromes; Chronic pain; Chronic pelvic pain; Complex pain; Neuropathic pain; Pelvic pain.

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Conflict of interest statement

Disclosure E JB. De Disclosures: Laborie Medical Technologies, Glycologix, Flume catheters, Luca Biologics: Consultant. Alight: Second Opinions. Ironwood Pharmaceuticals: advisor and investigator. Cambridge Medical Experts, Legal Med: Legal Expert. ERYP, Doximity: Investor. NIDDK: Co-Investigator and DSMB Chair. www.facingpelvicpain.org Web site. YouTube Channel https://www.youtube.com/channel/UCAMGEaCdxPL4bIFZnKbK8ng. M. Mekonnen, MS: The author has nothing to disclose. K. Leong, MD: No disclosures. B. Wells: No disclosures.