May is officially Pelvic Pain Awareness Month as of 2017! As a pelvic health physical therapist that treats pelvic pain regularly, I am incredibly happy that this is out and open to the public eye. Pelvic pain affects both women and men of all ages.
As most of you know, my mother is a gynecologist. She says that about 10-15 of her patients have a diagnosis of pelvic pain on a weekly basis. Pelvic pain presents differently for every individual. “Googling” pelvic pain and the signs and symptoms is not helpful due to the overwhelming amount of answers you will get. It is best to reach out to your primary care provider or ob/gyn and discuss your signs and symptoms. Pelvic pain can be musculoskeletal, hormonal, dermatological, and/or medical.
What is pelvic pain
According to the Amercian College of Obstetricians and Gynecologists (ACOG), chronic pelvic pain is described as “noncyclical pain of at least 6 months’ duration that appears in locations such as the pelvis, anterior abdominal wall, lower back, or buttocks, and that is serious enough to cause disability or lead to medical care.”
Prevalence
Chronic pelvic pain is a common problem. It is good to know that even though pelvic pain is very common, it does not mean it is normal. It affects approximately 1 in 7 women.
In one study of reproductive-aged women in primary care practices, the reported prevalence rate of pelvic pain was 39%.
In the United States, estimated direct medical costs for outpatient visits for chronic pelvic pain (women aged 18-50 y) is approximately $881.5 million per year.
Pelvic pain conditions
Pudendal neuralgia
Generalized pain- abdomen, pelvis, hip, groin, low back, Sacroiliac dysfunction
Specific pain- vulvar, testicular, penile, vaginal, clitoral, labial, rectal, tailbone/coccyx
Pain with sitting
Pain during bowel movements or voiding
Endometriosis pain
Interstitial cystitis (painful bladder syndrome)
Painful period
Vulvodynia
How does pelvic health physical therapy help with pelvic pain
The pelvic floor is always involved with pelvic pain symptoms; however, it may not be the cause. Treating the pelvic floor can significantly reduce symptoms of pelvic pain. Think of the pelvic floor muscles as any other muscle in your body. If you have restrictions/trigger points/tightness in your shoulder musculature then it can cause compression of joints, decreased range of motion and ultimately pain in the shoulder. If you have restrictions/trigger points/tightness in your pelvic floor muscle then it can cause your malalignment in pelvic bones and lumbar spine, pain in pelvic region, or decreased range of motion of pelvic floor musculature.
A pelvic health therapist can
- Determine source of pain or contributing factors
- Manual therapy
- Trigger point release
Trigger points are tight areas where a muscle is knotted, painful, and They can be tender to the touch, but they can also be referring pain throughout the pelvic region.
By releasing these trigger points – whether they are found on external muscles like the inner thighs, hamstrings, glutes, or abdomen, or whether they can only be reached internally within the pelvic floor, manual therapy eliminates these trigger points as a cause of pain and symptoms.
- Myofascial release
- Fascial tension occurs when the fascia; which is a thin layer of connective tissue between the skin and muscles beneath. It can become tender and inflamed.
- By releasing the fascial restrictions, inflammation can be reduced by increased blood flow to the area.
- Restore balance to pelvic region
- Pelvic pain can be coming from malalignment of the bony structures of the pelvis, hips, and back.
- Restoring proper alignment can improve the balance of the pelvic floor ultimately decreasing pain.
Merci Ortenzi Treaster is a pelvic health therapist at Functionize Health & Physical Therapy. She treats prenatal and postpartum clients, pelvic pain, urinary/fecal incontinence, constipation/ IBS, diastasis recti, and supportive dysfunctions. Merci received her Doctor of Physical Therapy degree from Mercer University.