In the past 10 years pelvic pain has become a more recognized diagnosis. Pelvic pain is now one of the most commonly diagnosed problems of women. Pain anywhere in the pelvic and abdominal area is usually labeled pelvic pain. Any pelvic pain needs to be evaluated immediately by your family practice doctor, OB/GYN or a Urologist. The acute onset of pelvic pain may indicate a serious medical condition such as a tubal pregnancy or appendicitis. Once the physician rules out a serious medical condition, they then will evaluate the area to determine where the pain is coming from.
WHAT CAUSES PELVIC PAIN?
The pelvis supports many organs, including the bladder, uterus, fallopian tubes, ovaries,intestines, and appendix. Any one of these organs can be painful and irritated, thus causing pain to the other structures around it. The pelvic floor muscles which support the organs of the pelvis may become tight and tender due to the irritation of one or more of the pelvic organs. The bladder is a common irritant of the pelvic floor. Irritation of the bladder is called Interstitial Cystitis. Frequently there is no obvious causing factor of pelvic pain. However, there can be other conditions that contribute to pelvic pain:
- Pelvic Inflammatory Disease
- Gynecologic adhesions
- Ovulatory pain
- Pelvic Congestion Syndrome
- Pelvic Organ Prolapse
- Chronic urinary tract infections
- Chronic bladder infections
- Irritable bowel syndrome
- Myofascial pain (trigger points)
- Degenerative Joint Disease
- Poor Posture
- Low back pain
- Muscular strain or sprain
- Bipolar Disorder
- Sexual trauma
Pelvic pain is considered chronic when it has been present for more than 6 months. Pelvic pain may be present in females of any age, not just the reproductive years. At Brookside we have treated girls as young as 8 years old and women into their 70’s. Men can certainly experience pelvic pain as well, as with chronic prostatitis, and physical therapists are trained at helping men as well as women.
HOW DOES PHYSICAL THERAPY HELP PELVIC PAIN?
Physical Therapy addresses any musculoskeletal involvement that is contributing to the problem.On the initial evaluation, the therapist will evaluate the back, legs and pelvis for any dysfunctions that need to be addressed. For women who have had pelvic pain for several years, there is usually involvement of the back and legs. In order to properly treat the area, all adjacent areas need to be normalized as well. On the first or second visit the therapist will perform a vaginal exam, similar to what the physician or gynecologist does. However, this is to determine the condition of the muscles in the pelvic floor area. If there is involvement of the back and legs, these are treated first. Once those areas are cleared up, the pelvic floor is addressed. In order to get the muscles of the pelvic floor to relax, we use various techniques. Frequently there is edema in the abdominal and pelvic cavities, which is impeding the healing process. We will address this with manual lymph drainage both in the clinic and with a home program. The reactivity of the pelvic floor muscles is treated using PRRT, gentle massage and biofeedback.
WILL PHYSICAL THERAPY HELP ME?
Pelvic pain is a very personal and emotional problem. If you have been diagnosed with pelvic pain or interstitial cystitis, and are not sure Physical Therapy will help, call for a free consult. Sue Moore, MS, PT , would be glad to talk with you about your concerns and the treatment approach we use.
There are many great resources available through the Internet. The ones we most commonly refer to are the International Pelvic Pain Society at www.pelvicpain.com, www.ichelp.org, and www.ic-network.com.