Chronic Pelvic Pain
Chronic Pelvic Pain is pain in the pelvic area that lasts for >6 months. Pain can come and go or it can be constant.
This pain originates or is strongly associated with pain in the muscles and soft tissue of the pelvic area.
It's COMPLICATED!
The muscular component of Chronic pelvic pain is an often unrecognized, under-appreciated and untreated component, frustrating for patients and specialists who are not getting the desired results from treatment.
Pain can start in a pelvic organ; bladder pain (for example interstitial cystitis) or the uterus (endometriosis) perineum (vulvodynia) or nerve entrapment (pudendal neuralgia). After several weeks the pain “spreads” to neighboring organs because the nerves that spread pain messages are “chatty” and talk to nearby organs and muscles.
Over time muscles become tense and painful, developing spasm and trigger points that need to be treated.
Pain can also start locally in the pelvic floor muscles due to constant strain on the muscles or direct trauma (childbirth injuries), postural, ergonomic or nutritional factors. Stress, depression and anxiety heighten pain symptoms. Overtime tender points develop that refer the pain to other nearby areas.
These tense muscles can contribute to urinary urgency/frequency, constipation, sexual pain, pudendal neuralgia, painful bladder syndrome, and other symptoms.
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Irrespective of where the pain starts, it overflows to adjacent muscles and organs and influences how you feel.
You might start restricting activity, have difficulty with your daily tasks at home and work. Sitting or standing for long periods may become uncomfortable, exercise and participating in your daily activities becomes more difficult.
How can Physical Therapy Help?
It starts with a detailed examination of the muscles in the lower abdomen and pelvic area, including sensory tests to indicate hypersensitivity or lack of sensation.
Above all, we look for tender points in the muscles connected to the pelvic area both external and intravaginal (to the extent you are comfortable).
We identify areas of pain, and treatment is initiated with soft tissue mobilization, trigger point release and encouragement towards increased participation in your daily activities and exercise.
We use specialized manual therapy techniques, specific exercise, stimulation and biofeedback if needed.
Education and Resources
Besides direct treatment, we have conversations to have insight as to what factors might be contributing to this problem; constipation? Poor body mechanics? Bladder problems? Nutritional issues?
Together we plan on making small changes over time to help you gain confidence and enjoy your life! Small Changes can make a Big Difference.