Pelvic pain can be confusing and scary. In reality, it's often simply tight muscles irritating the nerves that run through the pelvic floor. The good news? This can be addressed!
There are many different names for pelvic pain and dysfunction. Unfortunately this causes a lot of confusion among patients; in reality, the most likely culprit for the cause of pain is tight muscles in the pelvic floor irritating the nerves that run through the area.
When this happens it can cause pain anywhere the nerve runs. Often where the pain experienced isn't actually where the problem is. This is known as "referred pain" and is extremely important to understand in pelvic pain conditions.
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.
What is Referred Pain?
While it may seem confusing, we're actually really familiar with this type of referred pain.
With sciatica, tight muscles in the lower back irritate the sciatic nerve, radiating pain anywhere the nerve runs. The exact same thing can be happening within the pelvic floor.
It's also similar to the way tight muscles in the neck and shoulders can cause a headache. By releasing trigger points in the area, stretching the neck out and changing our posture, we can often alleviate or eliminate those headaches.
Another example? When you hit your funny bone. A lot of times it causes numbness, pain or tingling that shoot down to your hand.
All of these are examples of referred pain, and often this is exactly what is going on within the pelvic floor.
Common Sites for Referred Pain
Referred pain can occur throughout the pelvic girdle. For women, pain often refers to the vulva (usually diagnosed as "vulvodynia'), the bladder or urethra (diagnosed as 'interstitial cystitis), in the tailbone ('coccydynia'). It also refers to the suprapubic area below the belly button, inner thighs, and ischial tuberosity (just around the sit-bones). All of these are common areas for referred pain.
Men show similar referral patterns. Many times pain is experienced in the scrotum or tip of the penis, especially in conjunction with arousal or sexual activity. Rectal pain is common in both genders as well.
The Solution for Pelvic Pain
Fortunately, this type of pain can be resolved with skilled, manual physical therapy. A hands-on approach using both internal and external techniques can release these trigger points and tight areas, releasing pressure on the nerves.
Ultimately, it's important to get to the underlying "why" of the symptoms. It's never enough to just say "the pelvic floor is tight or hypertonic." Instead, we have to understand the why.
What else is causing that? How can we address it for lasting relief? These are the questions a skilled physical therapist can answer. At PelvicSanity, we say you should be seeing a significant difference in the first 3-5 visits of physical therapy. This doesn't necessarily mean wholesale improvement, but definitely signs you're on the right track.
If you aren't experiencing that relief, you may need to look for a second (or third, or fourth) opinion. There's a wide range of experience and expertise when it comes to pelvic floor physical therapy and many therapists are not trained in treating chronic pelvic pain conditions.
If you do need help finding a referral, feel free to contact PelvicSanity to see if we know anyone in your area or if there's another way we can help!
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.