How to Get Rid of Endometriosis Pain
- Nicole Cozean
- 3 days ago
- 4 min read
Endometriosis is known for chronic, often debilitating pain — from painful periods and bloating to painful intercourse and low back pain. While pelvic floor physical therapy does not cure endometriosis itself, it can dramatically reduce and manage the pain symptoms associated with the condition. For many patients, pelvic floor therapy is life-altering.
Introduction
Endometriosis pain can feel relentless.
Painful periods. Abdominal cramping and bloating. Pain with intercourse. Low back or flank pain. Constipation. Pelvic pressure. Fatigue. The list goes on.
Endometriosis occurs when endometrial-like tissue grows outside of the uterus, attaching to structures within the pelvic cavity. But here’s what surprises many people: research shows that the amount and location of endometriosis growth does not strongly correlate with how much pain someone experiences.
Someone with extensive endometriosis may have mild symptoms, while someone with minimal visible growth may suffer debilitating pain.
That tells us something important.
It tells us that endometriosis pain isn’t just about the lesions. There is something else driving symptoms — and that “something else” is often the pelvic floor, abdominal muscles, fascia, and nervous system.
In this article, we’ll explain what causes endometriosis pain, why surgery doesn’t always resolve it, and how pelvic floor physical therapy can help you get lasting relief.
What Causes Endometriosis Pain?
Endometriosis is the root diagnosis — but it is rarely the only driver of pain.
When endometrial-like tissue implants outside the uterus, it creates inflammation within the pelvic cavity. That inflammation irritates surrounding tissues and triggers a protective response from the body.
The muscles of the abdomen and pelvic floor tighten to guard the area. Over time, they develop painful trigger points and tender spots. These tight, irritated muscles compress nerves that run through the pelvis.
Those muscles and nerves become the immediate cause of symptoms, including:
Painful periods
Abdominal cramping
Bloating
Constipation
Low back pain
Painful intercourse
Pelvic pressure
So while endometriosis initiates the process, the muscles, nerves, and fascia of the abdomen and pelvic floor often sustain and amplify the pain.
This is why pain severity doesn’t always match lesion severity. The nervous system and muscular system are heavily involved.
Why Doesn’t Endometriosis Surgery Resolve All Endo Pain?
Excision surgery can be incredibly helpful for many patients. Removing visible endometriosis lesions can reduce inflammation and disease progression.
But many patients are surprised when pain lingers after surgery.
Why?
Because even if every visible lesion is removed — which can be difficult — the muscular trigger points and nervous system sensitization remain.
In some cases, surgery adds additional layers of complexity:
Surgical incisions
Scar tissue formation
Adhesions
Post-operative inflammation
These factors can further irritate surrounding tissues and maintain pain signals.
Think of it this way: if your muscles have been guarding and tightening for years, removing the initial irritant does not automatically teach them how to relax.
That’s why surgery and physical therapy are not competing treatments. They are complementary.
Pelvic Floor Physical Therapy for Endometriosis
Pelvic floor physical therapy does not remove endometriosis lesions.
But it can be transformative for managing pain.
A qualified pelvic floor therapist addresses:
Trigger points in abdominal and pelvic floor muscles
Scar tissue and adhesions
Nerve irritation
Core dysfunction
Bowel dysfunction
Painful intercourse
Low back and hip involvement
By calming the muscles and nerves that are perpetuating pain, therapy can significantly reduce symptoms.
For some patients, pelvic floor therapy allows them to:
Delay surgery
Avoid repeat surgery
Reduce reliance on medication
Improve daily quality of life
For others, therapy plays a critical role after excision surgery.
Every orthopedic surgery in the body — knee, shoulder, hip — is followed by physical therapy to restore mobility and prevent scar restrictions. Yet pelvic and abdominal surgeries are often sent home without rehabilitation.
Pelvic floor therapy after excision surgery can:
Improve healing
Reduce scar tissue restriction
Decrease inflammation
Restore normal muscle function
Prevent recurrence of pain patterns
Even if you’ve already had surgery and still have symptoms, therapy can help restore function and reduce ongoing pain.
How to Find a Qualified Pelvic Floor Therapist for Endometriosis
Endometriosis is complex. It requires specialized care.
If you are seeking pelvic floor therapy for endometriosis, look for someone who:
Specializes exclusively in pelvic health
Has experience treating endometriosis specifically
Understands chronic pain science
Is comfortable performing internal and external treatment
Works collaboratively with medical providers
You want someone who sees endometriosis regularly — not someone who “dabbles” in pelvic health.
If you are local to Southern California or Orange County, we would absolutely love to work with you.
At PelvicSanity in Laguna Hills, we have a comprehensive endometriosis program that treats the body holistically. We have helped hundreds of women reduce or eliminate the pain associated with endometriosis. We also work closely with excision specialists and other medical providers to ensure coordinated care.
If you are not local, we encourage you to find a qualified pelvic floor therapist near you who has experience in chronic pelvic pain and endometriosis management.
You deserve a team that understands both the medical and musculoskeletal aspects of this condition.
👉 Request an Appointment to begin working with our pelvic health specialists.
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Who are We at PelvicSanity?
At PelvicSanity, it's our mission to support patients with pelvic pain and pelvic floor symptoms, regardless of where you live. We can help with:
In-person treatment for those in Southern California at the PelvicSanity clinic
Immersive Out-of-Town program for those able to travel
Remote Consultations to get you expert 1:1 help, advice and an action plan
Online patient courses on Interstitial Cystitis and Movement for Pelvic Health
A Facebook support group for patients called Finding Pelvic Sanity.
Dr. Nicole Cozean is the founder of PelvicSanity Physical Therapy in Orange County, CA. PelvicSanity treats patients from all over the world with remote consultations and the Immersive Out of Town Program. She also runs Pelvic PT Rising, training other pelvic PTs to better serve patients.
Named Physical Therapist of the Year, Dr. Nicole is author of the award-winning book The Interstitial Cystitis Solution and the first PT to serve on the ICA Board of Directors, Her passion is helping those with pelvic health issues - regardless of where they live - find lasting relief.
Thank you for such informative insights on managing endometriosis pain! I'm curious, how do lifestyle changes compare to medication in effectiveness for different individuals? Also, I can't help but think of the slope rider analogy—navigating those ups and downs must be quite a journey. Your thoughts?