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Physiotherapy for Chronic Pelvic Pain

Often chronic pelvic pain cannot be “cured” but rather managed through a variety of medical and non-medical interventions. Pain that persists despite treatment of underlying conditions may be due to changes in the brain and understanding this is an important part of management.

Chronic pelvic pain is defined as a non-malignant, intermittent or continuous pain in the pelvis or lower abdomen.

Chronic pelvic pain can be caused by a number of pelvic and abdominal issues. It becomes chronic when the pain persists for at least 3-6 months. It is estimated to affect 15-25% of women and 10% of men.

What does chronic pelvic pain feel like?

Chronic pelvic pain (CPP) is pain below the belly button and between the hips that lasts for 6 months or longer. It can be described as a severe and steady pain, pain that comes and goes, a dull ache, sharp pains/cramping or a pressure/heaviness within the pelvis itself.

Chronic pelvic pain symptoms

You may experience pain symptoms as described above, but also pain with intercourse, bladder and bowel dysfunction, bloating, period pain, pain with ovulation or pain sitting/standing for long periods of time. Pain may be relieved by lying down. The pain may be mild and annoying, or severe and impact your ability to work, sleep or exercise.

Chronic pelvic pain causes

Chronic pelvic pain may be caused by the following:

  • Endometriosis
  • Adenomyosis
  • Musculoskeletal problems (fibromyalgia, pelvic floor tightness, hernia etc)
  • Interstitial cystitis or painful bladder syndrome
  • UTI
  • Pelvic inflammatory disease
  • Pelvic congestion syndrome
  • Irritable bowel syndrome
  • Uterine fibroids
  • Vulvodynia
  • Psychological factors can increase your risk of CPP or make your pain worse

Chronic pelvic pain treatment

Often chronic pelvic pain cannot be “cured” but rather managed through a variety of medical and non-medical interventions. Pain that persists despite treatment of underlying conditions may be due to changes in the brain (see pain and the brain) and understanding this is an important part of management.

There are different hormonal therapies, lifestyle adjustments, psychotherapy, physiotherapy or osteopathy, medications and alternative therapies such as mindfulness, yoga and acupuncture, which can be helpful. Chronic Pelvic pain is best managed by a multidisciplinary team of health professionals.

Physiotherapy for chronic pelvic pain

Physio for chronic pelvic pain may include pain education, pelvic floor exercises, implementing good bladder and bowel habits, mindfulness, yoga, treatment of muscles or joints that are tight/weak/painful to reduce symptoms. A physio will work with your other health professionals to help manage your symptoms.