Chronic Pelvic Pain: What to Do When You've Been Told "There’s Nothing Wrong"
For many individuals suffering from chronic pelvic pain, it can feel like you're stuck in a never-ending cycle. You’ve been to doctor after doctor, explained your symptoms over and over, only to be told that "everything looks normal" or "there’s nothing wrong." Yet, you continue to experience debilitating discomfort in your pelvic area or lower abdomen. The frustration of having your pain dismissed can be isolating, but it's important to know that your pain is real and that help is available. Pelvic floor physical therapy could be the key to uncovering the root cause of your pain and offering a solution.
The Struggle: Years of Unanswered Questions
Chronic pelvic pain in the lower abdomen or pelvic region can take many forms. You might experience dull pain, cramping, a feeling of heaviness, or even sharp, stabbing sensations that seem to come out of nowhere. For years, you might have been told “everything looks fine” on imaging and labs, that your symptoms are “all in your head” or a result of stress. But the truth is, chronic pelvic pain often doesn't show up clearly on standard tests, which is why it's often dismissed.
You might have been diagnosed with conditions like irritable bowel syndrome (IBS), endometriosis, or interstitial cystitis, only for the treatments to fall short. You may have tried pain medications, antibiotics or other therapies without lasting relief. When nothing seems to work, it’s easy to feel helpless. The frustration of knowing something is wrong, but not having a clear answer from medical professionals can leave you feeling emotionally drained and physically defeated.
Often, patients endure so much pain without the support they need from their medical team that they feel the need to take matters into their own hands, researching their condition in hopes of finding the relief they deserve. Add to that the overwhelming amount of conflicting information available, and it’s easy to see how patients can feel even more confused, hopeless, and uncertain that relief from their pain is truly possible.
So, What’s Really Going On?
It’s possible that your pelvic pain may be due to pelvic floor dysfunction. This occurs when the muscles at the base of your pelvis, called the pelvic floor, become weak, tight, or imbalanced. The pelvic floor muscles are responsible for supporting the organs in your lower abdomen and also play a key role in controlling bowel and bladder function, as well as sexual function.
When these muscles become dysfunctional, they can cause a wide variety of symptoms, including:
Chronic lower abdominal or pelvic pain
Pain during or after intercourse
Urinary urgency, frequency or incontinence
Constipation or difficulty with bowel movements
A feeling of pelvic heaviness or pressure
Unlike conditions that are visible on tests like ultrasound or x-ray, pelvic floor dysfunction often goes undiagnosed because it doesn’t show up on imaging.. This is why many people suffer for years without clear answers.
Pelvic Floor Physical Therapy: A Game-Changer for Chronic Pelvic Pain
Pelvic floor physical therapy is a specialized form of therapy that targets the muscles of the pelvic floor. It helps assess and treat the underlying causes of pelvic pain, including pelvic floor dysfunction.
Here’s how pelvic floor physical therapy can help you when nothing else has worked:
1. Understanding Muscle Imbalances
Your pelvic floor muscles should work in harmony to support your pelvic organs and maintain proper function. When they’re too tight or weak, or they don’t work together properly, pain and dysfunction can occur. A pelvic floor physical therapist will perform a thorough evaluation of your pelvic floor muscles, looking for areas of tightness, weakness, or imbalance.
In many cases, chronic pelvic pain can be caused by hypertonic (overactive) pelvic floor muscles that are in a constant state of contraction, even when they should be relaxed. This muscle tension can lead to pain in the pelvis, lower abdomen, and even down the legs. By addressing these imbalances, a PFPT can provide relief and help restore proper pelvic function.
2. Manual Therapy to Release Tension
For individuals with chronic pelvic pain, manual therapy can be incredibly beneficial. A PFPT will use hands-on techniques to release tight muscles and fascia in the pelvic region. These techniques can include soft tissue mobilization, myofascial release and address trigger points that can reduce muscle tension which may be contributing to your pain.
Addressing this tension can help improve blood flow, reduce pain, and improve the ability for the pelvic floor to move freely and appropriately during your everyday activities.
3. Addressing Scar Tissue and Nerve Irritation
If you've had previous surgeries, childbirth, or pelvic trauma, scar tissue and nerve irritation could be contributing to your chronic pain. Scar tissue can cause muscles and tissues to become stiff and bound together, restricting movement and causing pain.
Pelvic floor physical therapists can use gentle techniques to improve the mobility of this scar tissue, restoring normal movement and relieving the tension that may be exacerbating your pelvic pain. Nerve irritation can also play a role, and a skilled PFPT can assess and treat nerve involvement using specific techniques to help reduce compression around the nerves.
4. Education and Exercises for Long-Term Relief
One of the cornerstones of pelvic floor physical therapy is educating patients about their own bodies. A PFPT will teach you how to properly coordinate and perform pelvic floor exercises to relax the muscles, depending on your specific needs. These exercises can be especially helpful for maintaining pelvic health and preventing future flare-ups of pain.
Additionally, PFPT often includes teaching strategies for proper posture, body mechanics, and even breathing techniques. By improving the way you sit, stand, and move, you can reduce strain on the pelvic floor, helping to ease pain over time while continuing to do the things you love.
5. Nervous System Down-Training: Calming the Pain Response
Chronic pelvic pain can also be linked to an overactive nervous system, where the body’s pain response becomes heightened and more sensitive over time. This can lead to a cycle of constant discomfort, even in the absence of any new injury or physical problem. Nervous system down-training focuses on calming this overactive response and teaching the body to “reset” its pain threshold.
Through specialized techniques like deep breathing, progressive muscle relaxation, and mindfulness practices, a pelvic floor physical therapist can help you learn to regulate your nervous system. These tools teach you how to manage stress, reduce muscle tension, and improve your body’s ability to cope with pain. By incorporating nervous system down-training into your treatment plan, you can break the cycle of chronic pain and regain control over your body’s response to discomfort.
What to Expect from Pelvic Floor Physical Therapy
If you're ready to explore pelvic floor physical therapy, here's what you can expect during your first visit:
Comprehensive Assessment: Your therapist will take a detailed history of your symptoms, medical background, and any previous treatments you’ve tried. They will also ask targeted questions about your pain to gain a deeper understanding of its underlying causes. This helps them understand your unique situation and develop a personalized treatment plan.
Internal and External Evaluation: Depending on your symptoms and level of comfort, your therapist may perform an internal and/or external examination of your pelvic floor muscles. This can help identify muscle tightness, weakness, or dysfunction.
Treatment Plan: Based on your evaluation, your therapist will design a treatment plan tailored to your needs. This may include hands-on therapy, exercises, and techniques to improve pelvic floor muscle function.
Follow-up Visits: PFPT is typically an ongoing process. Through regular visits, your therapist will monitor your progress, adjust treatment, and continue to provide strategies for managing your pain long-term.
Is Pelvic Floor Physical Therapy Right for You?
If you’ve been struggling with chronic pelvic pain and haven’t received a clear diagnosis or effective treatment, pelvic floor physical therapy may be the answer you’ve been searching for. PFPT is a holistic, non-invasive approach that can address the underlying causes of pelvic pain, helping to reduce muscle tension, improve function, and restore balance to your pelvic region.
It’s time to stop accepting that your pain is just something you have to live with. Pelvic floor physical therapy can offer significant relief for those who have been told “everything is normal” and are ready for a solution that works.
Conclusion
Living with chronic pelvic pain can feel like an endless struggle, especially when you're repeatedly told that nothing is wrong. It can also be difficult to explain your condition to those close to you, as they may struggle to fully understand the severity of your pain, which can strain relationships. But your pain is real, and there are effective treatments available. With the right treatment, you can begin to enjoy life without being held back by pain. Learn more about the services that we provide here!
If you’ve been told there’s nothing to be done, it’s time to take control. Conveniently located in Rhode Island, we are able to offer 1:1 55–60-minute appointments to help you reach your goals. Reach out or book your first session today and start your journey toward healing.
