Endometriosis and Nerve Involvement: The Reasons Why Pain Spreads Through the Body

If severe pain that begins in the pelvic region can spread over time to the hip, the leg or the back, one of the underlying causes may be Endometriosis and nerve involvement. Foci settled particularly in areas close to nerve tissue can cause widespread pain that advances along the nerve, not only in the area where they are located. This situation requires a special approach in terms of both diagnosis and treatment.

Nerve involvement is endometriosis foci placing pressure on the pelvic nerves – by settling around structures such as the sacral nerve plexus, the sciatic nerve and the inferior hypogastric nerve in particular – or affecting them directly. This situation:

Widespread and deep pelvic pain

Pain felt in the hip, the leg or the back

Sometimes numbness, tingling, a burning sensation

Severe pain that increases with movement

can show itself with complaints such as these.

Our nervous system is at the centre of the pathways that transmit pain in the body. When endometriosis tissue comes into contact with a nerve or surrounds it, pain signals can spread along that nerve. This in turn can lead to a pain that begins, for example, in the lower abdominal region being felt:
In the hip,

In the leg,

And even as far as the ankle.

Widespread pain of this kind can sometimes be attributed to an orthopaedic or neurological problem. Yet the underlying cause may be endometriosis.

Noticing nerve involvement with traditional methods may not always be easy. For this reason taking a detailed history, a correctly directed physical examination and advanced imaging methods are of great importance. 
Particularly in non-standard descriptions of pain, gynaecological assessment can often be overlooked.
Specialised pelvic MRI techniques

Detailed gynaecological examination

Laparoscopy if necessary (closed surgical diagnosis and treatment)

play an important role.

In situations of this kind the treatment process is different from classic pain management. What needs to be focused on is not only relieving the pain but eliminating the structure that is affecting the nerve. If necessary, surgical intervention can be planned with a multidisciplinary team. An operation carried out with the correct technique and experience can enable pain that has lasted for years to disappear.