Imagine waking up in the morning, and suddenly, the pain starts. You try to get ready for your day, but a part of you wants to lie down with a heating pad. Some other days, you have bladder pain with a constant urge to empty the bladder, making it difficult to focus on work. And on top of that, there is also painful intercourse.
It is estimated that 1 in 7 women experience pain in the pelvic region. Many people do not realize how common it is because it is not something we often talk about. Think about the last time a friend or family member opened up about the pain they were feeling. And when was the last time you spoke to someone about your pain?
Pelvic pain can have a significant impact on your quality of life. It can interfere with work, social activities, and intimate relationships. The good news is that there are treatments available that can help.
What is pelvic pain?
The pelvic region is the area under your belly button and between your hips. It includes your reproductive organs, urinary system, and digestive system. The most common location where people experience pelvic pain is located in the pelvic floor muscles.
Pelvic pain can be sharp or dull. It may come and go, or it may be constant. The intensity of pain is different for everyone. It can be mild or severe. Some people have pelvic pain that is so severe that they cannot stand, sit, or have sex. There are two different kinds of pain you could be living with: acute pain, which is sudden and severe, or chronic pain, which comes and constantly goes for six months or longer.
It is important to note that not all pelvic pain is caused by a single issue. Many women experience pelvic pain from a combination of different conditions.
What are the common symptoms of pelvic pain?
Pelvic pain will be different for everyone and can be accompanied by various symptoms. They include:
- Tailbone pain
- Pain with sitting for long periods
- Pressure or heaviness deep within the pelvis area
- Sharp pains or cramping in your abdominals and pelvic muscles
- Pain in the lower back sacroiliac joint, hip, groin
- Pain with urination
- Urinary frequency, urgency and difficulty with initiation
- Urinary Incontinence
- Pain with bowel movement
- Pain during and after sexual intercourse
- Pain in the vulvar or interlabial area
What causes pelvic pain?
There is no simple answer to this question, as finding the cause of your pelvic pain can sometimes be complicated. Your body is an incredible creation of interconnected systems, and sometimes pain can be caused by one thing or a combination of several conditions. With your pelvic physiotherapist, you can work together to address your pelvic pain but discovering the root cause of your pain may take time.
Some conditions that can cause or contribute to pelvic pain include:
- Repeated urinary tract infections and vaginal infections
- Connective tissue scarring or nerve irritation from pelvic surgery
- Hormonal issues, specifically low estrogen level
- Irritable bowel syndrome
- Interstitial cystitis (painful bladder syndrome)
- Polycystic ovarian syndrome
- Pelvic congestion syndrome
- Pelvic inflammatory disease
- Ehlers Danlos
- Vaginal delivery
Due to the complex nature of pelvic pain, a multidisciplinary approach is essential for pelvic pain healing, and having a pelvic physiotherapist on your team is crucial for your recovery.
How can pelvic floor physiotherapy support pelvic pain?
Most pelvic pain syndromes are caused by a neuromuscular problem, involving the muscles, nerves, and connective tissue of the pelvic floor and adjacent areas. A physiotherapist, who specializes in pelvic health, will have the best understanding of the pelvic floor muscles and able to treat pelvic floor dysfunctions effectively.
The first step of the treatment begins with an evaluation.
At InvigoPhysio, we believe in the importance of getting a thorough medical history. You will be asked in detail about the start and severity of your symptoms, factors that make your pain worse or better, the treatments you’ve had in the past and whether they have helped you and many other questions to gather as many clues as possible. As a result, we will be able to determine why you might be in pain and what needs to be done.
The next part of the evaluation is the physical exam which begins with an external observation of any impairments in the abdomen, hips and low back with emphasis on the areas that are relevant to your symptoms. We will assess the quality of connective tissue, muscle strength and any structural abnormalities. The final step is the internal examination of the pelvic floor. Most people are worried about pain and discomfort caused by the internal pelvic floor assessment; however, it should be gentle and provoke minimal pain within your tolerance. It is important to communicate this with your pelvic physical therapist. It is possible to check your pelvic floor muscles with minimal discomfort.
If you’re curious to learn what an initial pelvic assessment, including an internal exam, might be like, we have your questions covered here in another blog post. At InvigoPhysio, we’re here for YOU, and a big part of that is ensuring you feel comfortable and heard from the moment you book and through every step of your healing journey.
After your pelvic floor assessment, your pelvic physiotherapist will create a personalized treatment plan that takes into consideration your level of pain, symptoms, lifestyle and schedule, and health goals.
Your treatment is always customized to meet your needs and can include:
- Internal and external manual therapy to address the local tissue impairments
- Education on the involved anatomy and management of your condition
- Relaxation techniques to calm down the nervous system
- Gentle acupuncture to reduce pelvic pain externally
- Yoga movement therapy to improve mobility and blood circulation
- Pilates-based exercises to restore overall core strength
- Because everybody is unique, every treatment should be too.
Some other questions we often get about treatment are:
When should I come in?
If your pelvic pain is interrupting your day-to-day activities or if your pain is steadily getting worse, it’s time to get support from a pelvic floor physiotherapist. The sooner you start treatment, the less irritated your tissue becomes, and it doesn’t spiral into other issues. This also reduces the length of your recovery.
How long will treatment take?
There is no set answer because everyone is unique. Depending on your pain level and the cause of your pain, recovery may differ for each person. Our goal at InvigoPhysio is to bring you relief from pain and help you recover. If you have specific goals, please make sure to get them to our attention so we can discuss how to work towards them together.
What does pelvic pain management look like?
While the end goal will be recovery from pain for most people, there is a lot that needs to be done to manage pain. If you’re living with chronic pelvic pain, a goal you likely have is to manage your day-to-day discomfort or distress.
As part of the treatment plan, you will be started on a movement program that includes stretches and specific strengthening exercises based on your body’s needs and abilities. These gentle movements will improve blood circulation and help alleviate pain and start you towards recovery without constantly relying on painkillers.
We recognize that starting to be active after a long period of pain can trigger any pain-related anxieties, and that’s why it’s crucial to have a personalized program that is adjusted for your body’s current level of comfort and strength.
Besides breathing exercises and mindfulness techniques, we also believe in having different tools that you can use at home to manage and treat your pelvic pain, such as heating pads, labial and vaginal moisturizers, dilators, and pelvic wands.
A combination of home treatment and hands-on in-clinic physiotherapy treatment will make a huge difference. And that’s our goal – to make a difference to help you get back to living your life your way.
Will Kegel exercises help me?
While Kegels are probably the most COMMON pelvic floor exercise that the everyday person knows about, it’s not always the solution to pelvic floor dysfunctions.
Popularized by shows like Sex and the City, Kegels can be a part of treatment plans depending on the condition. However, they could also be harmful to you if they’re done incorrectly or not suitable for your specific pelvic floor issue.
Kegels can’t magically heal your pelvic pain, ‘just like that,’ but maybe they can address this misconception in the upcoming season of ‘And Just Like That’!
So that leaves the most important question you probably have:
What do I do if I’m living with pelvic pain?
Make an appointment with a physiotherapist who specializes in pelvic floor therapy. You can ask, and your physiotherapist will be able to let you know if they specialize in treating pelvic pain.
If you’re looking for a physiotherapist who specializes, InvigoPhysio has you covered!
Trang Bùi, MSc PT, personally understands the challenges of getting in touch with your pelvic floor, and she knows from experience how hard it can be to find the right advice and guidance.
Using evidence-based knowledge and techniques, she’s dedicated to finding effective ways to treat pelvic floor disorders in men and women across the Greater Toronto area.
Specializing in pelvic floor care and with a holistic care skillset including manual physical therapy, neurofunctional acupuncture, yoga, Pilates and more, Trang is here to help you recover from pelvic floor pain.