A woman lying on the couch holding her abdomen

Pelvic pain physical therapy – understanding causes and pelvic pain treatment

Pain is a normal and common human experience. Pain prompts us to pause, pay attention to our surroundings, and decide whether to stay still or move. However, living in pain isn’t normal. Each pain experience is unique and important, especially pelvic pain. But what exactly is pelvic pain? And where does it come from? 


Pelvic Floor Function

The pelvic floor muscles are the muscles in the bottom of the pelvis. They support the pelvic organs such as the bladder, urethra, uterus, prostate, and rectum. They also play an important role in controlling the bladder and bowels, regulating intra-abdominal pressure, and maintaining sexual function. Because the pelvic floor muscles impact so many systems, pelvic pain be present in any of the following areas: 

  • Lower abdomen 
  • Vulva / vagina 
  • Pubic symphysis joint 
  • Penis, scrotum, or testicles 
  • Perineum / perineal body 
  • Bladder
  • Anus / gluteal region 
  • Tailbone

Low back pain and/or hip pain are often present as well, due to the close relationship between the musculature of the low back, hip and pelvic floor region. It is important to determine the root cause of pelvic pain to determine the best pelvic pain treatment option. 

Pelvic anatomy - female

What causes pelvic pain?

Pelvic pain can have many causes, such as scar tissue, stress, hormonal dysfunction and changes, stiff muscles and joints, muscle weakness, bowel and bladder dysfunction, medications, a sensitive nervous system, lifestyle habits, and various conditions such as endometriosis, Ehlers Danlos Syndrome, interstitial cystitis, irritable bowel syndrome, and more.

While having names for conditions like interstitial cystitis and endometriosis can be helpful, pelvic pain presents very differently for each person. The brain produces pain when it perceives something as a threat. While guarding and protecting an area is helpful as a short-term solution, our “alarm system” can become so overly sensitive that any and all movements reproduce pain. This is why so many structures and systems could be involved depending on what the brain interprets as a threat, environmental factors, lifestyle habits, and body function. 

There are many pelvic pain treatments, but physical therapy is an excellent first line treatment option.

How can physical therapy help with pelvic pain?

The good news - pelvic therapists are trained to tackle these issues. There are many physical therapy intervention options for pelvic pain, such as mobility drills, hands on therapy for involved muscles and tissues, dry needling, strengthening exercises, and more. We will also work with your doctors on your medical team (such as urology, OB/GYN, gastroenterology, and primary care physician) if other interventions are needed. 

Check out our Rise Pelvic Therapy Instagram to learn more about pelvic conditions and how physical therapy can help. You can also go to our website for answers to commonly asked questions about pelvic physical therapy.

Unsure if pelvic physical therapy is right for you? Request an appointment with one of skilled Doctors of Physical Therapy, and we’ll chat and create a game plan to address your needs. We see patients one-on-one in a private room for all pelvic therapy appointments, ensuring your comfort and privacy. 



Written by Gabi Back-Kremers PT, DPT 



Photo by Sora Shimazaki: https://www.pexels.com/photo/woman-suffering-from-a-stomach-pain-lying-down-on-couch-5938351/