- Pelvic pain generally refers to burning, itching, aching or other types of pain in the vulva, vagina, perineal, and/or anal area
- Women with pelvic pain often suffer from pain with intercourse, may experience hypersensitivity when wearing pants and/or underwear, and may have pain with sitting
- Exercise may provoke or exacerbate symptoms
- In addition to pelvic pain, women can also experience urinary urgency, frequency, pain with urinating, and/or urinary leakage
- Women may suffer from abdominal bloating, gastrointestinal distress, and constipation
- Symptoms can be provoked, meaning with penetrative intercourse or tampon insertion, or unprovoked and spontaneous
- Symptoms can be intermittent or constant
Causes of Pelvic Pain
- Repetitive vaginal and/or bladder infections and/or gynecologic, urologic, dermatologic or gastrointestinal conditions
- The majority of women with pelvic pain have pelvic floor dysfunction
- Prescription medications such as oral contraceptives, acne medications, and hormonal suppressive therapies for diseases such as Endometriosis and Polycystic Ovarian Syndrome (PCOS)
- Surgical trauma (childbirth, pelvic organ prolapse repair, hysterectomy)
- Orthopedic injuries or traumas
- Biomechanical or structural dysfunction (hip dysfunction, sacro-iliac joint dysfunction, piriformis syndrome, scoliosis, leg length discrepancy)
- Vaginal childbirth
- Genital cutting or genital mutilation
Diagnoses such as Endometriosis, Vulvodynia, Interstitial Cystitis/Painful Bladder Syndrome, Pudendal Neuralgia, Lichen Sclerosus, Lichen Planus, and Irritable Bowel Syndrome are associated with pelvic pain and pelvic floor dysfunction.
Research shows that it can take up to five years for women with pelvic pain to get a proper diagnosis and up to 11 years for a woman with Endometriosis. This is because the symptoms of pelvic pain can mimic conditions such as urinary tract, yeast, bladder and sexually transmitted infections. When the pelvic floor is the culprit, the diagnostic tests for these infections are negative, leading to confusion for both the medical provider and the patient. Many medical providers are not aware that pelvic floor dysfunction can cause pelvic pain and it certainly does not occur to women to go to physical therapy when these symptoms arise. The majority of our patients tell us they did not know they even had a pelvic floor until things started to go wrong!
Treatment: How We Can Help You
Women experiencing pelvic pain can benefit from an evaluation with a pelvic floor physical therapist specializing in pelvic pain. During the evaluation, the physical therapist reviews your history and symptoms with you, what you have been diagnosed with in the past, the treatments you have undergone and how effective or not effective these treatments have been. Importantly, we understand what you have been going through and that most women are frustrated by the time they get to see us. During the physical examination the physical therapist examines muscles, tissues, joints, nerves, and movement patterns. Once your physical therapist completes the examination they review your findings with you. The physical therapist creates an assessment which explains how you developed pain and creates short and long-term goals for your treatment plan. Typically, the frequency of physical therapy treatment is one to two times per week for roughly 12 weeks. You are given a home exercise program to compliment your in-person sessions, and your physical therapist will help to coordinate your recovery with the other members of your treatment team. We are here to help you recover and live your best life!