About two years ago, I had severe back, hip, and knee pain. During physical therapy for my lower back, my physical therapist suggested the symptoms I was experiencing may not be what they appear to be, and guessed that it might be pelvic floor related, as his wife had a similar experience.
Turns out, he was right, and I began pelvic floor physical therapy with a specialist. However, even though I felt some relief in my back, the referred knee pain did not subside. Turns out, while the pelvic floor pain contributed to the knee pain significantly, I needed to seek alternative methods of therapy with knee exercise and knee recovery machines, and to talk with my orthopedic doctor regarding whether surgery was needed or not.
First, I had to address the pelvic floor symptoms. According to the Mayo Clinic, “Pelvic pain is pain in the lowest part of the stomach area and pelvis. It can refer to symptoms that come from the:
- Reproductive system, which includes the organs and tissues involved in pregnancy and giving birth.
- Urinary system, which removes waste from the body through urine.
- Digestive system, which takes in, digests and absorbs nutrients from food and drink.
- Pelvic pain also can refer to symptoms that come from muscles and connective tissue called ligaments in the pelvis.
Depending on its source, the pain can be:
- Dull or sharp.
- Constant or off and on.
- Mild to severe.
The pain can spread to the lower back, buttocks or thighs. You might notice it only at certain times, such as when you use the bathroom or have sex,”.
To stay ahead of the pain, here are some treatments that were suggested to me for pelvic pain:
- Pelvic floor physical therapy (specialty): A specialized treatment focused on relieving pelvic pain and improving pelvic muscle function, combining stretches, exercises, and relaxation techniques that target muscles and connective tissues in the pelvic region. By strengthening and relaxing these muscles, this specialized therapy has been proven to reduce pain and improve urinary and bowel function.
- TENS units: (transcutaneous electrical nerve stimulation) are a non-invasive treatment option for chronic pelvic pain. They send electrical impulses through the skin, which help block pain signals from reaching the brain, thus providing immediate pain relief.
- Massage therapy: Relieves chronic pelvic pain by promoting relaxation, reducing muscle tension, and improving blood flow to the pelvic region. Therapeutic massage techniques such as myofascial release and trigger point therapy can help release tight muscles and alleviate pain. Additionally, massage can improve overall well-being and reduce stress and anxiety often associated with chronic pain. The myofascial release component is incredibly beneficial to many suffering from pelvic pain.
- Epsom salt baths: Regular Epsom salt baths relieve chronic pelvic pain as these salts contain magnesium sulfate, known for its muscle-relaxant properties. When dissolved in warm water, Epsom salts can help alleviate pelvic muscle spasms, reduce inflammation, and promote relaxation. Soaking in an Epsom salt bath for about twenty minutes a few times a week can relieve pain significantly. In fact, I do it every night before bed!
- Flexural (cyclobenzaprine): This muscle relaxant is prescribed to relieve pelvic muscle spasms and reduce pain by blocking pain signals from the muscles to the brain, thereby providing temporary relief.
- Anti-inflammatory over-the-counter medications: For mild to moderate chronic pelvic pain, over-the-counter anti-inflammatories such as ibuprofen or naproxen sodium may be recommended; however, it is crucial to consult a healthcare professional before using these medications long-term or at higher doses.
- Surgery: To remove adhesions, fibroids, and/or endometriosis
Chronic pelvic pain is a debilitating condition that significantly impacts quality of life. Yet, each person’s experience with chronic pelvic pain is unique, and treatment approaches almost always vary, so it is imperative to consult with a healthcare professional specializing in pelvic pain to determine the most appropriate and effective treatment plan.
*Note: All content within this article is meant for informational purposes only and is in no way a replacement for professional medical or psychological advice or support. Seek immediate and appropriate care from a healthcare professional should you or a trusted loved one deem it necessary.
Is it normal to have pelvic pain every day?
Unfortunately, for some, the answer is yes. And, because chronic pelvic pain is often caused by an abnormal function of the nervous system, it may be linked to other types of conditions, such as:
- Psychological conditions
- Anxiety
- Depression
- Gastrointestinal conditions (discussed further below)
For example, when someone is under continuous stressors that exacerbate their anxiety, there may be a tendency to “internalize” the stress, therefore causing the core muscles to tense up constantly.
Stress contributes to pelvic pain by activating the body’s stress response system, also known as the fight-or-flight response. When a person perceives a threat or a stressful situation, the body releases stress hormones such as cortisol and adrenaline. And when stress becomes chronic, the constant release of stress hormones can ultimately lead to muscle tension and inflammation.
In the context of chronic pelvic pain, continuous stressors can lead to the tightening of muscles in the pelvic region, manifesting as pelvic muscle spasms or trigger points, causing discomfort and pain.
The pelvic muscles are interconnected with other muscles and connective tissues, such as the abdominal and lower back muscles. When the pelvic muscles tighten due to stress, it can create a cascade of tension and pain throughout the pelvic area, as well as referred pain, as we discussed earlier.
What diseases cause pelvic pain?
As mentioned above, gastrointestinal issues can contribute to pelvic pain. Some gastro and other causes could include:
- Appendicitis
- Colon cancer
- Constipation
- Crohn’s disease
- Diverticulitis
- Intestinal obstruction
- Irritable bowel syndrome
- Ulcerative colitis (a type of inflammatory bowel disease)
Pelvic pain or pressure is common for ovarian and uterine cancers as well. More frequent or urgent need to urinate and/or constipation are common for ovarian and vaginal cancers, so it is exceptionally imperative to seek medical attention immediately should you experience any concerning pelvic pain.
Pelvic pain symptoms
In conclusion, pelvic pain is complex and very personal — but with the right medical team and treatment plan, meaningful relief is absolutely within reach.