Other Pelvic Pain

The sheer number of conditions related to our pelvic floor shows how vital it is to our health. Here, we break down some common conditions that can trigger pelvic pain, and how you can regain control of your pelvic floor muscles – and relieve your pain.

What Conditions Can Cause Pelvic Pain?

We’ve covered many conditions that can cause pelvic pain, but there are still others worth mentioning. These include:

• Irritable bowel syndrome

• Endometriosis

• Menopause

• Painful bladder and urinary tract infections

• Post-gynecological or abdominal surgeries, such as Caesarean sections and laparoscopy 

Let’s dive a bit deeper into a few of these below.

Irritable Bowel Syndrome (IBS)

IBS is a term that has become used more and more in everyday language. But, what is it exactly? IBS is a chronic (long-term) condition involving significant abdominal pain, bloating and discomfort. It may also cause bowel dysfunction, including infrequent stools, straining during a bowel movement, and being unable to completely empty the bowel. IBS is categorized based on whether it is accompanied by constipation (IBS-C), diarrhea (IBS-D) or a mix of these two symptoms (IBS-M). If you think you may have the symptoms of IBS, contact your doctor. They’ll do specific tests to make a diagnosis.

Treatment for IBS is often a combination of medication, education and dietary changes. Pelvic Health Physiotherapy is another pillar of care for those suffering with abdominal and pelvic discomfort from IBS.

Endometriosis

Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus (called extrauterine sites). These sites may include the ovaries, bladder, bowel and recto-vaginal septum (the thin structure separating the vagina and the rectum). This abnormal tissue growth can lead to inflammation and the formation of scar tissue called adhesions in the pelvis and other areas. Endometriosis is a fairly common condition, occurring in 10-15% of women (and trans males) worldwide.

Individuals suffering from endometriosis often experience dysfunction in their pelvic floor. This is because chronic inflammation and adhesions can cause the surrounding pelvic muscles to protectively contract to guard the area of pain. Over time, this can create areas of muscle tightness, weakness, and a lack of coordination. Pelvic floor dysfunction can lead to significant pelvic pain (including the back – which often stems from pelvic floor muscles), which can interfere with activities requiring these muscles, like sex, urinating and exercise. Read more about Endometriosis

Menopause

Menopause is medically defined as when a woman has had at least 12 consecutive months without having a period. Typically, people enter menopause between 40 and 58 years of age, with the average being 51. You may also have heard the term peri-menopause. Peri-menopause is the time period leading up to menopause. Peri-menopause lasts, on average, 6-8 years and often begin in one’s mid-to-late 40’s or early 50’s. During this phase, people experience fluctuations in hormone levels (primarily estrogen and progesterone), which can lead to a variety of symptoms. Common symptoms of menopause and peri-menopause include:

• Systemic symptoms (meaning in the body), such as night sweats, hot flashes, fatigue, insomnia, weight gain, mood swings, and memory issues.

• Local symptoms (within the pelvis and vulvovaginal area), such as irregular menstrual cycles, urinary urgency and frequency, urinary incontinence, vulvo-vaginal dryness, decrease in muscle flexibility, changes in vulvar skin texture, burning, itching and skin irritation.

During menopause and peri-menopause, estrogen and progesterone levels decrease over time. Both hormones are vital to collagen production and building muscle mass. So as levels lower, muscles in the pelvic area (and elsewhere in the body) start to weaken and the surrounding collagen (which supports our muscles) begin to thin. This can lead to pelvic health conditions, including bladder leakage, prolapse, and pelvic pain. Decreased estrogen levels can also lead to vulvo-vaginal dryness, which is considered a hallmark symptom of menopause. Read more about Menopause

What Is The Role of The Pelvic Floor in Pelvic Pain Disorders?

The pelvic floor is a group of muscles, ligaments, and connective tissue that are located at the bottom of the pelvic bones. The pelvic floor is our body’s foundational core, providing:

• Support to the pelvic organs

• Stability for the low back and hip joints

• Support for the bowel and bladder

• The framework for sexual sensation and arousal

When working optimally, the pelvic floor muscles are able to dynamically relax and contract.

Pelvic floor dysfunction occurs when the muscles of the pelvic floor are weak, too tense or not tense enough. Pelvic pain is usually the result of overly tense pelvic floor muscles – it’s as if they are always “on.” When there is a prolonged state of tension or contraction, this compromises the natural circulation of blood flow within the pelvis. As a result, the pelvic muscles can become painful and sore and the nerves that supply these muscles can become irritated. The pain may radiate to different areas of the pelvis including the low back, abdomen, and hips.

How Can Pelvic Health Physiotherapy Help Me?

If you are suffering from pelvic pain of any kind, including that related to one of the conditions above, Pelvic Health Physiotherapy

With pelvic pain, pelvic floor muscles are usually tight, so treatment will first focus on normalizing the pelvic floor muscle tone through a variety of techniques. Some strategies include:

• Manual therapy to help release your pelvic floor muscles.

• Exercises to strengthen the pelvic floor and innermost abdominal muscles, which you can continue to do on your own.

• Breathing techniques to more effectively using your whole ribcage, abdominal wall and pelvic floor muscles, to help lessen pain and release tight pelvic muscles.

• Biofeedback, a modality that can help retrain weak or poorly functioning pelvic floor muscles. An electrical or mechanical device may be used to help provide auditory or visual feedback on how well or poorly you are using your muscles. This feedback helps you to train muscle function more effectively to help reduce pelvic pain.

Once a normal pelvic floor resting tone is reached, a personalized strengthening program is then initiated to help you gain strength and flexibility. By regaining more control over your pelvic floor, muscle spasms and pelvic pain can significantly improve.

How Do We Approach Treatment For Pelvic Pain?

At Proactive Pelvic Health Centre, we are committed to providing a safe and comfortable place where clients can access multi-disciplinary pelvic care to help improve their quality of life.

Before pelvic floor treatment begins, your Pelvic Health Physiotherapist will take your full medical history and thoroughly discuss your current symptoms. We work with you to ensure we understand your pain experience: where is it, how does it feel, and when does it happen.

With informed consent, your Pelvic Health Physiotherapist will perform a complete physical assessment of the joints and tissues affecting this area. Based on the assessment, a personalized treatment plan will be developed to help you both identify and manage your symptoms. Our approach is compassionate, outcome-driven and holistic, ensuring the entire you is taken care of, mind and body.