Pelvic floor dysfunction
Pelvic floor dysfunction is a global term used to describe conditions such as pelvic organ prolapse, fecal or urinary incontinence, and chronic pelvic pain. Myofascial pain is one etiology of chronic pelvic pain of a myofascial origin. For women with pelvic organ prolapse and incontinence issues, the therapist develops a treatment program that addresses the weakness of the pelvic floor and related structures. Many experts believe that many, if not most, women with chronic pelvic pain have some degree of myofascial pelvic pain syndrome, a disorder in which pelvic pain is attributed to short, tight, tender pelvic floor muscles, usually with myofascial trigger points. Management of myofascial pelvic pain syndrome may also utilize pelvic floor muscle training, biofeedback in addition to manual therapy. However, additional forms of pelvic floor physical therapy may be employed secondary to the unique pathophysiology of this syndrome, which involves changes in the length tension relationship of the muscle, as well as changes in neural function.
Woman’s health therapy is private, confidential therapy that can help evaluate and treat the problem of:
- Sexual discomfort
- Urinary incontinence
- Pelvic pain
- Painful bowel movements or constipation
- Restricted movement of hips or lumbar spine
Pelvic Pain can be caused by pelvic joint dysfunction, muscle imbalance, or compression of nerves in the pelvic floor region.
- One in seven women 18 years and older experience chronic pelvic pain
- 61% have no diagnosis
- 12-16% have hysterectomies to alleviate the pain
- 47% then end up with continence issues
- Symptoms include: pain in lower abdomen/pelvis, hip or buttock pain, pain in the tailbone, limited sitting tolerance, pain with sexual intercourse, restricted movement of hips or lumbar spine, and painful bowel movements or constipation.
Physical Therapy can help pelvic pain by evaluating and treating potential causes of pelvic pain such as:
- Joint dysfunction
- Muscle tightness
- Weakness or imbalance
- Nerve entrapments
Our Physical Therapists can help you gain control over your symptoms through:
- Re-training in-coordinated muscles with internal and external techniques
- Postural training
- Behavioral change
- Pelvic floor exercise
Education on food and drink that may irritate the bladder
Male Pelvic Pain Conditions
What is Chronic Pelvic Pain?
Chronic pelvic pain (CPPS), is defined as any pain/discomfort occurring below the navel that has lasted ≥3 months, with no bacterial involvement, and inconsistent micturition and/or sexual function complaints. CPPS can have a major impact on daily activities and quality of life. Recent statistics indicate that as many as 2.7-5% men between the ages of 18 and 50 experience pelvic pain, with many going undiagnosed. Additionally, 62% of these patients have some form of sexual dysfunction associated with their pain.
CPPS over time can begin to cause such symptoms as depression, anxiety, insomnia, decreased appetite, decreased physical activity, and fatigue. Oftentimes, when a clear cause has not been found patients are told that the pain is “all in their head,” resulting in feelings of hopelessness and eventual social isolation.
How does this affect your musculoskeletal system?
After experiencing pain for long periods of time, even organ-related pain, muscles can become tense and tight resulting in hypertonicity. This in turn can cause muscles to become ineffective, weak, and eventually painful. The muscles involved can be anywhere along the pelvic girdle (abdominals, buttocks, low back, quadriceps, hamstrings, and pelvic floor).
Treatment for CPPS
As from surgical procedures and medications, physical therapy can be a valuable option for conservative management of CPPS. A physical therapist can evaluate your abdomen, pelvis, legs, posture, and gait to look for areas of tenderness, weakness, and/or muscle dysfunction.
With physical therapy, you will receive one on one care using various techniques which may include manual hands-on external/internal soft tissue manipulation, therapeutic exercise, modalities, and more. You will also receive a custom home program to continue with once you have been discharged from treatment.
Diagnoses related to Pelvic Dysfunction
Cystitis (Painful Bladder Syndrome)
Testicular, penile, or scrotal pain
Urinary dysfunction including: incontinence, increased urinary frequency, and increased urgency
Bowel Dysfunction including: Irritable bowel syndrome, constipation, difficulty evacuation, and proctalgia fugax
Sexual dysfunction including: pain with arousal, erection, and/or ejaculation
Post-surgical including: prostatectomy, vasectomy, orchiectomy, neobladder, and other abdominal surgeries
Coccydynia (tailbone pain)
Abdominal or perineal pain
How to get started on your recovery?
Make an appointment with your physician and ask them to write a referral to a physical therapy clinic trained in pelvic health. At Action Therapeutics, we possess the specialized training to treat impairments related to chronic pelvic pain.
CPPS can be debilitating and life-altering. It does not have to be. While medications and surgical solutions can be helpful, new research is showing that physical therapy can be a great adjunct. A 2018 meta analysis found several studies which supported that physical therapy treatment is positively associated with better patient outcomes. Another study from 2015 found that patients with CPPS who participated physical therapy reduced their use of medication associated with CPPS.