Pelvic pain is a common but often misunderstood condition that affects both men and women. It can range from mild discomfort to debilitating pain, and can impact many aspects of daily life, including sexual health, bowel and bladder function, fitness, and overall quality of life. 

Unfortunately, because pelvic pain is such a sensitive issue, many people suffer in silence, unsure of what’s causing it or how to get help.

Pelvic floor physical therapy (PFPT) can be a game changer for those with pelvic pain (especially the kind that your physician can’t seem to give you a straight answer about!) –  But how do you know if it’s right for you? Let’s explore the various causes of pelvic pain and how pelvic floor therapy might provide the relief you’re seeking.

 

Common Causes of Pelvic Pain in Men & Women

1. Pelvic Floor Dysfunction – an issue of strength, length, or coordination.

One of the leading causes of pelvic pain is pelvic floor dysfunction. Your pelvic floor is a group of muscles that supports your pelvic organs, such as the bladder, uterus (for women), prostate (for men), and bowels. When these muscles become too tight, weak, or uncoordinated, it can lead to pain and dysfunction in the pelvis.  This may happen because of an injury, pregnancy/childbirth, or be a culmination of lifelong poor habits (think chronic constipation)

Signs you might have pelvic floor dysfunction:

  • Pain during sex (for women) or erectile dysfunction (for men)
  • Urinary urgency or frequency
  • Difficulty with bowel movements or constipation
  • Chronic lower back or hip pain (that hasnt responded as well as you hoped for with traditional orthopedic PT or other interventions)
  • Feeling of heaviness or pressure in the pelvis

2.  Endometriosis (or similarly, adenomyosis)  

Endometriosis is a condition in which tissue similar to the lining inside the uterus (the endometrium) grows outside of the uterus, causing inflammation, scarring, and pain. This is a condition that requires a multidisciplinary approach including GYN, nutrition, pelvic floor PT, and sometimes GI docs.  Pelvic floor physical therapy can help women manage pain associated with endometriosis by addressing the muscle tension and imbalances that often accompany this condition.

signs you may have endometriosis:

  • Severe menstrual cramps
  • Pain during or after sex
  • Abdominal / low back pain
  • Sometimes can be relieved with the help of hormonal  birth control options
  • Chronic pelvic pain, especially around your period
  • Difficulty getting pregnant

3.  Prostatitis (for men)

Prostatitis, or inflammation of the prostate gland, can cause pelvic pain, urinary issues, and discomfort. This condition can be bacterial or non-bacterial, but in cases where cultures are coming back negative, and antibiotics are not improving your pain levels,  pelvic floor muscle tension is often part of the problem. Pelvic floor therapy can help relieve muscle tightness and improve bladder and bowel control.

Signs you might have prostatitis:

  • Pain or discomfort in the lower abdomen, perineum, or penis
  • Painful urination or ejaculation
  • Frequent need to urinate, especially at night
  • Trouble starting or maintaining urination

4. Pelvic Organ Prolapse (for women)

Pelvic organ prolapse occurs when the pelvic organs, such as the bladder or uterus, drop from their normal position due to weakened pelvic floor muscles. This can lead to pelvic pain, pressure, and discomfort, especially when standing or lifting. Pelvic floor therapy can help women strengthen these muscles and manage the symptoms of prolapse.

Signs you might have pelvic organ prolapse:

  • A feeling of heaviness or pulling in your pelvis
  • Urinary incontinence or difficulty emptying the bladder
  • Pain during sex
  • A bulging sensation in the vaginal area

5. Chronic Pelvic Pain Syndrome (CPPS)

CPPS affects both men and women and is characterized by pain in the pelvic region that lasts for at least six months. The cause is often difficult to pinpoint, and may sometimes involve nerves that innervate the pelvic floor muscles, but pelvic floor dysfunction is frequently involved. Pelvic floor therapy can be a key component of treatment, helping to relax overly tight muscles, decompress affected nerves, and retrain proper movement patterns.

Signs you might have CPPS:

  • Ongoing pelvic pain without a clear cause
  • Pain that worsens with sitting or certain activities
  • Pain that radiates to the lower back, hips, or thighs
  • Urinary or bowel problems

6. Post-Surgical Pelvic Pain

Pelvic pain can also occur after surgery, such as a hysterectomy (for women) or prostate surgery (for men). Scar tissue and muscle imbalances after surgery can cause pain and dysfunction in the pelvic area, which pelvic floor therapy can help address.

Can Pelvic Floor Physical Therapy Help You?

If any of the symptoms listed above sound familiar, pelvic floor physical therapy can be an effective treatment option for you. PFPT is a specialized form of physical therapy that focuses on the muscles, ligaments, and connective tissues in the pelvis. A trained pelvic floor therapist can evaluate your symptoms and create a customized treatment plan to address your specific needs.

What to Expect from Pelvic Floor Physical Therapy:

  1. Comprehensive Evaluation
    Your therapist will assess not only your pelvic floor muscles but also your posture, core strength, and breathing patterns to get a full picture of what’s contributing to your pain.

  2. Manual Therapy
    This might include internal or external release of tight muscles, trigger point therapy, or myofascial release to reduce muscle tension and pain.

  3. Strengthening and Stretching Exercises
    Depending on your needs, your therapist will guide you through exercises designed to strengthen weak muscles or relax overactive muscles, improving function and reducing pain.

  4. Biofeedback and Relaxation Techniques
    If your muscles are too tight or difficult to control, biofeedback can help you learn how to relax and properly engage your pelvic floor. Relaxation techniques such as diaphragmatic breathing can also play a critical role in reducing pain.

When to See a Pelvic Floor Therapist

If you’re dealing with any of the following, it might be time to see a pelvic floor physical therapist:

  • Persistent pelvic pain that has not improved with other treatments

  • Difficulty with bowel, bladder, or sexual function

  • A history of pelvic trauma, surgery, or childbirth that left you with pain or dysfunction

  • Unexplained lower back or hip pain that hasn’t responded to traditional treatment

Take Control of Your Pelvic Health

Pelvic pain doesn’t have to control your life. Whether you’re a man or a woman, pelvic floor physical therapy can help you get to the root of your pain and restore function so you can live comfortably again. Don’t wait—reach out to a pelvic floor physical therapist to start your journey to relief today.

Ready to Find Relief?
At EM Pelvic Health, we specialize in treating pelvic pain through personalized pelvic floor physical therapy. Our experienced therapists will work with you to develop a treatment plan tailored to your specific needs. Contact us today to schedule an evaluation and take the first step toward a pain-free life.