What You Need To Know About Pelvic Pain

Pelvic pain is a topic I am asked about so frequently that it bears talking about from a variety of angles.  So many women and men live day in and day out with pain in their pelvic region, buttocks, genitals, pubic area, tailbone, groin, bladder, genitals, rectum. It can get in the way of day to day activities like sitting, walking, sleeping, sexual activity, exercising, working, or child care. It can change your mood, your focus, your ability to engage with people you want to (or just need to) spend time with and pay attention to. 

Often pelvic pain has a cause that originates from one of the pelvic organs, like the bladder, uterus, or rectum. Along with pain, there can be urinary symptoms like urgency, frequency, or incontinence. Maybe there’s been an injury to the pelvis, hips or spine, a difficult child birth, an infection, or a surgery that was difficult to recover from. But this region is also the center of your movement system. Your lumbar spine (low back), pelvis and hip joints are all in a small central area in your body, and all of your movements day to day flow from this center. There is also a lot of nuanced interaction between the organs and the muscles, bones, joints, nerves, and tissues that connect them all together. All of this can make it tricky to correctly diagnose and treat pain in the area. People with pelvic pain often find that they do not get a complete solution to their problem from the first medical provider (or first several) whom they seek help from.

If this is true for your or someone you care about, please realize that the “musculoskeletal system” or your movement system, needs to be taken into consideration. An especially important and busy set of muscles and nerves called the pelvic floor, often are a major source of why pelvic pain can persist even after a medical problem has been treated in the pelvis.  When these muscles have become tight, tense, tender, or weak, they can cause pain anywhere throughout the pelvis, lower abdomen, hips, buttocks, and even beyond. They can also make every day activities uncomfortable or more difficult. This can include anything like walking, sitting, squatting, wearing tight clothing, using the restroom, or having sex.

All of the above is true also for women and men. We all have a pelvic floor, and much of the anatomy is actually more similar than different!

There are so many different causes behind pelvic pain, that there is no one-size-fits-all answer to solving this complex problem. Even so, there are some strategies that can help ease the pain in many cases even with varying origins.

  1. Get some amount of physical activity every day that you possibly can. Even if your pain limits you from exercising the way that you used to, or the way that you would like to or think you should, any amount of movement is helpful, and is the first key to getting your physical function back. So as soon as a health care professional such as your physical therapist, primary doctor, or any other has ruled out a condition that would make mild physical activity dangerous, just get started. Choose something gentle and in small doses if that’s what feels okay, and just get started. The consistency is much more important than the intensity. If you need help, we can lend a hand and give you guidance.
  2. Make quality of sleep a top priority.  A very high percentage of people with pelvic pain that has persisted for more than 3-6 months, also have difficulty sleeping. Lacking good sleep tends to make their pain worse, and the pain also interferes with sleep, leading to a difficult cycle. There are helpful things that you can do to improve your sleep quality even just a little bit, such as turning off all electronic screens 1 hour before going to bed, going to bed and getting up at a consistent time every day, and limiting naps during the day. These and other guidelines like it are called sleep hygiene, and can make a noticeable difference in the quality of sleep. And when it comes to pain, every strategy that helps even a little bit, starts to get you moving in a better direction. And better is… well, better!
  3. Educate yourself about your pain,– with accurate information. Many peoples’ first stop in finding solutions for pelvic pain is to consult with Dr. Google. While the wide availability of health information these days is a wonderful thing about the digital age, it can also lead you down unhelpful paths. Having inaccurate information about your pain has been shown to be worse than having no information at all – it can actually make your pain hurt more! Seek out answers from trusted specialists to make sure that you are learning truth rather than hype. A couple of recommended resources are the International Pelvic Pain Society (IPPS), and the research of neuroscientists like Dr. Lorimer Moseley. The modern science of pain is more than just interesting – knowing about it can help you feel better and get healthier.

So, whoever you are and whatever your story may be leading up to the pelvic pain that you or your loved one may be experiencing now, please know that you are not alone, and that there is help! Want to know more about how to get help?

Schedule a courtesy phone call with us by calling (650) 947-8500.

Kim Gladfelter

Kim Gladfelter, PT, MPT, OCS, FAAOMPT, is a physical therapist and owner of PhysioFit Physical Therapy & Wellness in Los Altos, CA. Kim's facility has a complete wellness center, offering classes in Pilates, Yoga, Gyrotonic® and TRX suspension training, as well as special clinical programs for women’s health. Kim works with people aged 30-65+ on a daily basis and is an expert Columnist who writes health articles for the Los Altos Town Crier newspaper, professional newsletters and blogs nationwide. She also reaches out to the local community, support groups, schools, libraries and sports centers to advise and educate on body awareness and exercise for back pain.
Kim Gladfelter

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