Chronic Pelvic Pain

Chronic Pelvic pain is  misunderstood and misdiagnosed. 70% of patients presenting with pain will have  associated pelvic floor dysfunction with the  presence of trigger points and tension. The pain can be diffuse throughout the pelvis or localized to one area .Pain can range from severe to mild. It is important to explore the root causes and identify any maintaining triggers. Pelvic pain may have been triggered by:

  • Trauma to the Pelvic Floor during Childbirth
  • Chronic Constipation
  • Urinary Tract Infections (where the pain continues even after the infection has cleared)
  • Vulvodynia
  • Interstitial Cystitis
  • Uro/Gynecological surgery
  • Certain inflammatory conditions
  • Overactivity of the Pelvic Floor Muscles
  • Direct Trauma to the Pelvic Floor
  • Injury to the Sacrum or Coccyx
  • Connective Tissue disorders

My treatment protocol involves releasing trigger points and tight muscles through manual therapy, and teachs patients how to reduce the tension in their pelvic floor through specific exercises. Connective tissue manipulation is often required to reduce myofascial pain and improve blood flow. The aim is to restore normal balance within the pelvic floor and to resolve the pain. Helen Keeble who works alongside Maria is also a specialist of Pelvic Pain and practisces Dry Needling. A combination of treatment techniques and tools helps with recovery and reduction of pain.

Embracing an holistic approach is key to understanding and treating pelvic pain. I find  patients often benefit from addressing the following areas, in addition to receiving manual therapy and  relaxed breath work :

  • Minimising levels of stress and anxiety - It's common for some people to hold their tension within their pelvic floor muscles (in the same way that some people hold their tension in their shoulders). Continual tightening of those muscles can create pain, which of course causes more tension, setting off a vicious pain-stress-pain cycle - breaking that cycle can help quieten down an aggravated pelvic floor. My patients often find meditation, relaxation exercises and/or cognitive behavioural therapy helpful for this. 
  • Diet -  Some patients find that spices, acidic foods, caffeine and/or alcohol increase their bladder pain and/or urgency. Identify your triggers. Promoting an alkaline environment is recommended. Toxins and allergies can compromise your immune system. For some helpful diet advice for IC checkout Dr Matia Brizman's website here: www.icaroadtorecovery.com.
  • Sleep hygiene - Restorative sleep is vital for recovering from any chronic pain condition, and there are some simple steps that can improve sleep quality. 
  • Breathing patterns - The pelvic floor muscles are directly affected by the way we breathe - in particular, breathing high up in the chest means that the pelvic floor muscles don't move freely, and can become tight and painful.  There are various exercises that can reverse poor breathing habits.  It is important to use the breath and the diaphragmatic descent to release the pelvic floor and allow lengthening.