January 15, 2017 Liza Colimon, MD Chronic pelvic pain often occurs not just due to uterine or ovarian causes, but because of muscle spasms and disorders of the pelvic floor and the nerves that supply them. A careful gynecologic exam from an experienced provider will be able to identify disorders of the pelvic nerves and muscles which may cause pain and pinpoint lifestyle factors that may also increase pain. When lifestyle modifications and pain medications are not helpful, nerve blocks and trigger point injections may be reasonable option. Small amounts of anesthetics are used to pinpoint areas and nerves that are causing pain. These pelvic blocks provide only temporary relief of pain so they are often used in combination with other therapies such as pelvic physical therapy and medical management. If the pain originates from specific large muscle groups, these muscles can also be injected with Botox, which may be helpful but only provides temporary relief.