Chronic Pelvic Pain

Pelvic pain is often misunderstood and misdiagnosed. It is frequently associated with an overactive pelvic floor, the presence of trigger points and tension. The pain can be diffuse throughout the pelvis or localized to one spot.  Pelvic pain has many causes, including:

  • 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
  • Adhesions following Surgery
  • Disorders of Overactivity of the Pelvic Floor Muscles
  • Direct Trauma to the Pelvic Floor
  • Injury to the Sacrum or Coccyx

My treatment protocol involves releasing trigger points and tight muscles through manual therapy, and teaching patients how to reduce the tone in their pelvic floor through specific exercises. The aim is to restore normal balance within the pelvic floor and to resolve the pain.

A holistic approach is key to understanding and treating pelvic pain, and I find that patients often benefit from addressing the following areas, in addition to receiving manual therapy and following the exercises:

  • 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 - For example, some patients find that spices, acidic foods, caffeine and/or alcohol increase their bladder pain and/or urgency.
  • 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.