It is estimated that over 25% of cis-gendered women and 17% of cis-gendered men will experience pelvic pain at some point in their lives, and if you find yourself somewhere within that statistic, know that you are not alone. Pelvic pain can often be a difficult thing to treat, not because it’s impossible to treat, but because it can get missed entirely, mis-diagnosed, or treated in a way that does not take into account all of the factors that can contribute to the development of pelvic pain.
What causes pelvic pain?
First, some definitions. Pelvic pain can include anything within the “bowl” of the pelvis: The pubic bone, the pelvic organs themselves, such as the bladder, intestines/bowel, and reproductive organs; the external genitalia, the groin and inner thigh, the lower abdominal muscles, the hip muscles, the buttocks, the SI joint, the tailbone, and even the low back.
By the time many of our patients make it to pelvic floor physical therapy, they’ve already undergone tons of testing: X-rays, abdominal CT scans, MRIs, diagnostic ultrasounds, lab work, and perhaps a pelvic or rectal exam. However, these tests—while still valuable—don’t always necessarily do a great job of showing what might be the root cause of someone’s symptoms, whether that be a tight muscle, pelvic floor weakness, a strained ligament, or even an irritated nerve. Whatever the cause may be, it may not necessarily show up on imaging studies, because sometimes our patients may only feel pelvic pain when they are in a certain position, like sitting, or doing a certain activity, such as walking, riding a bike, or being intimate with a partner.
Physical therapy for pelvic floor pain
Very often, patients have gone through multiple medical visits and seen a number of different providers and specialists, whether that be their OB/GYN, a urologist, a GI specialist, a back pain specialist, and more. While each area of the medical field has its own specialty, what we find is that similar to the phrase, “It takes a village to raise a child,” it often takes a team of medical professionals to comprehensively treat pelvic pain from a variety of different angles.
What pelvic floor physical therapy can do is add a unique perspective to this team of medical professionals. We take the pelvic floor and look at it from a musculoskeletal lens: Are the muscles of the pelvic floor too tight? Too weak and therefore not helping to support the whole system? Are the bones and joints of the pelvic floor in an optimal position? Is there too much laxity or stretchiness within the connective tissue and ligaments of the pelvic floor? Are there certain positions or movements that seem to make this pelvic pain better or worse? How can we change or adapt a sitting surface or an activity to be more accommodating or comfortable for our patient? Finally, we consider whether there are lifestyle or environmental factors that can be modified to reduce the stress and anxiety surrounding a person’s pelvic pain.
Together, we work with the other members of our patients’ health care team to ensure that they receive confidential but comprehensive and supportive care. If you or a loved one has been suffering from pelvic pain, pelvic floor physical therapy may be able to help. To schedule an appointment, visit the Des Moines University Physical Therapy Clinic website or call 515-271-1717.