Pelvic floor physical therapists successfully treat women with pain in and around the pelvis. This includes the lower abdomen, low back, groin, vagina, rectum, perineum, and tailbone.
We conduct a thorough examination to determine the sources of your pain. Pain may originate in the pelvic organs; scar or endometrial tissue; pelvic or spinal nerves; joints of the back, pelvis, and hips; or muscles of the back, hips, abdomen or pelvic floor. Once we determine the causes of your pain, we work with you to help you meet your goals. There are several common types of pelvic pain:
Levator Ani Syndrome or Non-Relaxing Pelvic Floor. The levator ani is the collective name for the group of muscles that forms the bottom, or the floor, of the pelvis. This group of muscles extends from the pubic bone in the front of the pelvis to the tailbone in the back. These muscles support the bladder, rectum and uterus. When these deep muscles become too tight or don't relax, they may pull the tailbone forward, causing pain in the rectum or coccyx that is often worse with sitting. Tightness in the levator ani muscles may also lead to difficulties with urination, defecation, and sex because all the pelvic orifices - anus, vagina, urethra - penetrate them.
Vulvodynia and Vestibulodynia. Vulvodynia is pain or discomfort in the female external genitalia lasting more than three months and not due to a skin condition or other diagnosed condition. Vestibulodynia is a specific type of vulvodynia that occurs at the opening of the vagina, inside the inner lips of the vulva. For more information, see the National Vulvodynia Association website.
Dyspareunia. Dyspareunia is pain that occurs with vaginal penetration during sexual intercourse. Dyspareunia may be superficial, happening during initial penetration, or may be deep and happen more with thrusting. Superficial dyspareunia is common after vaginal delivery, or with the onset of menopause. Deep dyspareunia may be associated with endometriosis, interstitial cystitis, levator ani syndrome, or uterine retroversion. History of sexual trauma may also lead to dyspareunia, as may several other conditions.
Vaginismus. Vaginismus is an instantaneous and involuntary tightening of the pelvic floor muscles in anticipation of vaginal penetration. It is most common after sexual trauma or painful pelvic medical procedure, but it may also occur for no apparent reason.
Decreased Sexual Pleasure. For some women, sex is not painful, but it is also not pleasurable due to laxity or weakness in the pelvic floor muscles responsible for orgasm. For others, the lack of enjoyment is a combination of physical, mental, and emotional factors. We treat the physical factors and recommend concurrent treatment with other professionals when necessary to help you enjoy your sex life to its fullest.
Interstitial Cystitis. Interstitial Cystitis is also known as Painful Bladder Syndrome. It is pain or pressure in the area of the bladder that is often accompanied by increased urinary urge or frequency. Bladder pain may be felt in the low abdomen, low back, or around the urethra, vagina, or rectum. For more information, please see the Interstitial Cystitis web site: https://www.ichelp.org/about-ic/what-is-interstitial-cystitis/
Endometriosis. Endometriosis, commonly called "endo," is a common condition that causes chronic pelvic and/or abdominal pain and painful periods. In endometriosis, tissue like that which lines the uterus (endometrial tissue) is deposited anywhere in the abdominal cavity including on the bladder, ovaries, bowel and other internal organs. Researchers believe the endometrial tissues build up in the abdomen, become engorged with blood, and shed inside the body, causing chemical buildup, scars, cysts, adhesions, and pain. Scars and adhesions may block the fallopian tubes and make conception and pregnancy less likely. Endo is a complex condition and may present differently for each woman. Symptoms vary from mild to severe and often vary with the menstrual cycle. To learn more about endometriosis, please visit: Endometriosis Association , or Endometriosis Foundation of America
Pudendal Neuralgia. This condition is pain coming from the pudendal nerve, one of the main nerves of the pelvis. It may present as burning, itching, or searing pain that is often worse with sitting and may affect bowel, bladder, and sexual function.
Orthopedic Conditions. Some conditions of the low back, lower abdomen, groin, hips, or tailbone are caused by conditions of the pelvic floor that refer pain elsewhere in the body. These conditions will not respond to conventional treatment because conventional treatment does not address the pelvic floor. Pelvic floor therapists are often successful at treating these types of pain.
For more information about Pelvic Pain, please visit The International Pelvic Pain Society web site.