Chronic Pelvic Pain

Physiotherapy is increasingly being used as a successful treatment for chronic pelvic pain, particularly for bladder pain syndrome (interstitial cystitis), endometriosis, pudendal neuralgia and pain secondary to pelvic surgery.

Physiotherapy aims to reduce symptoms, improve function and therefore improve quality of life.  Chronic pain is often best treated by a multidisciplinary approach, we therefore have links with other health care professionals and will recommend other therapies or treatment \ investigations as we feel necessary. 

What are the symptoms?

Symptoms vary from person to person, but the following symptoms are commonly reported

• Pain - can be steady (constant) or can come
  and go (intermittent)

• Pressure/heaviness in the pelvis

• Painful intercourse

• Pain during or after bowel movements or urinating

• Pain when sitting for a long time

• Urinary Incontinence

• Urinary frequency/urgency

• Sensation of incomplete bladder emptying

• Difficulty fully emptying the bowel

• Sleep disturbance/insomnia

• Anxiety/depression

• Memory problems.

What causes chronic pelvic pain (CPP)?

There are multiple possible causes and reasons for CPP, it is therefore important that you see your GP for appropriate investigations if you are having pain in the pelvis. 

Pelvic pain can be a symptom of another disease or it can be a condition in its own right.  Some common causes include endometriosis, bladder pain syndrome (interstitial cystitis), fibroids, IBS and pudendal neuralgia. This is not an exhaustive list, there are many more reasons for CPP. 

What does physiotherapy treatment include?

Often sufferers of chronic pelvic pain have overactive pelvic floor muscles, this can be overlooked by other health care professionals and is an underestimated cause for pain. 

An internal examination of the pelvic floor muscles can determine whether your muscles are overworking, tense and painful.  Physiotherapy can help with releasing these muscles, which often reduces symptoms of pain and of bladder, bowel and sexual dysfunction.

Physiotherapy will also help guide you to calm down the pathways that feed in to pain, we focus a lot on relaxation, breathing techniques, acupuncture and stretching. 

Usually external assessment and treatment of the pelvis, legs and abdomen is also required.