While we treat many different issues in pelvic therapy involving the urinary, GI, and reproductive systems, the majority of our patients come to us with some type of pain. Many of them have had pain for an extended period of time, and often no one has been able to help them find relief or even explain why they are having pain. It is highly distressing to be experiencing chronic pain, particularly when it appears to be a ‘mystery!’
Tension of the pelvic and surrounding musculature can cause pelvic, abdominal, hip, and low back pain, and this will be the subject of many future blog posts. Today we will be offering an overview of known diagnoses related to or causing pelvic pain so that we will all be familiar with the terminology.
Pelvic and abdominal pain is defined as any pain experienced from the lower ribs to the bottom of the pelvic region. This includes:
- Upper abdomen, lower abdomen, and groin
- Vaginal opening, vaginal canal, testicles, and penis
- Perineum (the area including the genitals and anus)
- Bladder and urethra
- Rectum
- Low back, sacral, tailbone, hip, and pubic bone
This pain may feel:
- Crampy
- Dull
- Achy
- Sharp
- Burning
- Stinging or raw
or any combination of those symptoms. Many patients with abdominopelvic pain also have additional issues with urinary, bowel, or sexual dysfunction.
More on Common Types Of Pelvic And Abdominal Pain:
– Vaginismus:
Partial or complete spasming of the vaginal muscles
– Dyspareunia:
Pain with intercourse
– Vulvodynia/Vestibulodynia:
Pain, burning, stinging, or rawness of the vaginal opening or perineum
– Interstitial Cystitis:
Interstitial Cystitis is characterized by three or more months of pelvic pain and urinary urgency and frequency symptoms. Typically examination of the lining of the bladder will find painful lesions.
However, please be aware that most patients with pelvic pain and urinary symptoms do NOT have IC!
– Low Back/SI Joint/Tailbone/Hip Pain:
Tight pelvic muscles can pull on the coccyx and sacrum and cause alignment issues in the low back and hip
– Abdominal or Groin Pain:
Pain and tenderness in the abdomen, groin, or the inside of the thigh
– Testicular or Genital Pain:
Some men describe a feeling of a sore testicle or generalized pain in the testicular area. Women may have pain in the labia or at the opening of the vaginal canal.
Common Diagnoses Causing Pelvic And Abdominal Pain
Diseases that affect the organs in the abdomen may cause pelvic pain, including the bladder, stomach, liver, pancreas, spleen, gallbladder, kidneys, intestines, and reproductive organs.
Endometriosis
Endometriosis is a painful tissue disorder for women where the uterus’s lining (the endometrium) grows outside of the uterus. It behaves like regular uterine lining and bleeds at the end of the cycle. Since it does not have an exit from the body, it can cause inflammation, adhesions, and scar tissue.
Endometriosis is a common condition and may also cause pain or bleeding between periods, painful sex, or difficulties getting pregnant. It can also adhere to the bowel and bladder and cause urinary or GI symptoms.
Adenomyosis
Adenomyosis is similar to endometriosis. In this case, the uterine lining migrates inside the uterus itself. This can cause pelvic pain as well as issues with painful sex, prolonged menstrual cramps, and heavy bleeding.
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome is a disorder that affects between 3-20% of Americans. Some people with IBS have constipation, some have diarrhea or loose stools, and some have both. Many also report abdominal pain, bloating, and gas.
Pelvic Inflammatory Disease
Pelvic inflammatory disease is an infection of the female reproductive organs. It affects roughly 5% of women and can be caused by different types of bacteria.
Crohn’s Disease:
Crohn’s disease is a condition that causes inflammation of the gastrointestinal tract walls and causes pain. Any part of the gut can be affected by Crohn’s disease.
How Are Pelvic And Abdominal Pain Diagnosed And Treated?
As you can see, there are many potential conditions causing or contributing to pelvic and abdominal pain. While this pain may be caused solely by pelvic and abdominal muscular tension, a trained pelvic therapist will be alert for medical diagnoses that should be considered. If warranted she will advise you on seeking out the expertise of another medical provider, such as a primary care or family medicine doctor, gynecologist, urologist, gastroenterologist, and/or pain specialist, if you have not already done so.
Many of the medical conditions that cause pain in the abdomen or pelvis also affect the pelvic floor and cause it to tighten. This pelvic muscle tension can then worsen pain and other symptoms, such as urinary or GI symptoms or pain during sex. Even when another treatment is required, pelvic floor physical therapy can help optimize healing and reduce pain in many situations.
Pelvic therapy will include hands-on manual techniques to improve the tissue quality in the abdomen and pelvic floor, reduce adhesions, and relax the muscles. Education will be provided on the cause(s) of your pain and changes you can make to reduce your pain. You will be taught strategies and techniques to prevent or better manage pain episodes.
When Should You Seek Treatment For Pelvic And Abdominal Pain?
Immediately! Many people suffer for years with pelvic and abdominal pain, hoping that it will resolve on its own. There is no need to suffer – there is treatment that can help! Schedule an in-person or Telehealth visit today.
If you experience any sudden or unusual pain that does not clear up on its own in a few days, do consult with your doctor. If you experience more severe symptoms, such as severe pain, fever, vomiting, or inability to pass gas or urine, you should seek medical help right away. This may be a sign of a more severe condition.
How Grace Physical Therapy Can Help
At Grace Physical Therapy, we have expertise in the inter-relationships of the urinary, bowel, reproductive, musculoskeletal, and neuromuscular systems. We see the connections in your symptoms and strive to help you make sense of them, as well as determine the best path to healing.
Pelvic physical therapy can help resolve or reduce your pelvic pain. Don’t suffer any longer; schedule a consultation today.
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