• Emily Reul, PT, DPT

Chronic Pelvic Pain

Updated: Oct 18, 2020

May is pelvic pain awareness month. Almost 1 in 4 women experiences chronic pelvic pain. (Zondervan, 2001) Yet women with pelvic pain are often left feeling helpless and hopeless. While chronic pelvic pain is more common in women due to many factors like pregnancy and childbirth, it can also happen to men, too!


WHAT DOES CHRONIC PELVIC PAIN MEAN?

Chronic pelvic pain is a broad term that describes any pain in the pelvic region. Typically, pain must be present for at least 6 months to be described as chronic.


Pelvic pain can be very difficult to describe and pinpoint as it is often diffuse or in more than one area. Your providers may use fancy words like dyspareunia (pain with intercourse) or vulvodynia (pain around the opening of the vagina) but don’t be intimidated.


People who suffer from chronic pelvic pain often have to seek help from multiple healthcare providers, and often are still do not get the care they need. Women with chronic pelvic pain are often told to “have a glass of wine and relax,” or are told that there is nothing wrong with them. It is estimated that $881.5 billion is spent annually on outpatient medical visits to address chronic pelvic pain! That's a lot of money, especially considering many women don't find symptoms relief.


While anyone can have chronic pelvic pain, the following can make someone more likely to develop it: delivery of a large baby or difficult delivery, vacuum or forceps delivery, an episiotomy, muscle weakness and poor physical conditioning, lumbar lordosis (increase natural curvature in the lower spine), a history of abdominopelvic surgery, a fall (especially on the tailbone), and pelvic organ prolapse.


There are several different conditions that can contribute to chronic pelvic pain including: interstitial cystitis, vulvar pain syndromes, endometriosis, IBS, infective cystitis (bladder infections), hemorrhoids, anal fissures, and more.


SO WHY DO WE CARE ABOUT PELVIC PAIN?


It has been shown to have profound effects on both the physical and emotional health of women. With chronic pelvic pain, women are more likely to have depression, sleep disorders, and a history of abuse. It’s hard to live a normal life when you are constantly in pain!


Surprisingly, studies have shown that chronic pelvic pain is just as common as migraines, back pain, and asthma. We all know someone who has these conditions, or maybe suffer from them ourselves. Imagine each of those people suffering daily from chronic pelvic pain!


Because chronic pelvic pain can present itself in so many different ways and it can be caused by a wide array of problems, it is best to seek help from a medical profession to address your symptoms. With that said, if a medical professional tells you just to “deal with it,” do yourself a favor and find a new provider.


Pelvic floor physical therapy is a great place to start to address chronic pelvic pain. Most states in the US have direct access, which means you can see a PT without needing a referral from a physician. And the great news—pelvic PT is covered by most insurances!


A pelvic PT can help in so many ways! One of the biggest ways a PT can help is through education. The PT can explain to you the anatomy of your body and the way it functions. Understanding this, can be a big step towards managing your pain. They also help you to recognize habits you may have and help you to create new, healthy ones.


They can provide relaxation training and biofeedback (down training) to help relax tight pelvic floor muscles. They can also use manual therapy techniques, such as massage and trigger point release, to help relax the pelvic floor and surrounding muscles.