A chronic infection refers to an infection in the body that lasts for an extended period of time, such as weeks, months, or even years. A chronic infection can be persistent and recurrent, and can occur in many areas of the body.

There are many different types of infections, but in this article, we’ll specifically be referring to chronic infections that affect the pelvis, such as the following:

• Urinary tract infections
• Reproductive infections (pelvic inflammatory disease)
• Yeast infections
• Vaginal infections
• Prostatitis
• Post-surgical infections
• And more

We’ll discuss some of these chronic infections in more detail later, but it is important to understand the effects they can have on the body—especially long-term.

Experiencing chronic infections often means an individual has long-lasting pain, inflammation, or irritation of the pelvis, nerves, and nearby tissues. This can lead to tissue damage and muscle dysfunction, particularly in the pelvic floor.

The pelvic floor is a major group of muscles found in the pelvis, which support your pelvic organs and many different functions. These muscles allow for bladder, bowel, and sexual function, as well as stability and balance for the entire body.

These muscles are very interconnected with the entire pelvis and even other structures such as the hips and lower back. This interconnectedness means that infections such as the ones listed above can have a significant impact on the health of your pelvic floor.

This is why individuals who experience chronic infections often have lasting symptoms such as pelvic pain, lower back pain, muscle strain, incontinence, hypersensitivity, bowel or bladder pain, sexual dysfunction, and more.

These symptoms are not always a direct result of the infection itself, but rather a dysfunction caused by long-term and recurrent inflammation, pain, scarring, or adhesions.

Individuals experiencing these painful symptoms as a result of their chronic conditions can often benefit from pelvic floor physical therapy, which can reduce muscle tension, address pain, and improve bladder, bowel, or sexual function.

We’ll talk more about how pelvic floor physical therapy can support those who experience chronic infections soon, but first we’ll go over some common chronic infections.

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Now that you understand how long-term infections can have an impact on your pelvic floor health, let’s take a look at some types of chronic infections and their individual effects.

Some of the conditions explored below are actually not caused by infections, but are often mistaken as infection due to their symptoms. These chronic conditions can cause long-term effects of pain and pelvic floor dysfunction too, so they’ve been included in the following list:

Conditions Mistaken for Infection

Interstitial Cystitis: This condition causes an individual to urinate more often but in small amounts. It is associated with pelvic pain and painful urination. It is not an infection, but is often misdiagnosed as a UTI.

Chronic interstitial cystitis can contribute to pelvic floor dysfunction from bladder pain and muscle tension. Additionally, chronic infections can lead to interstitial cystitis.

Chronic Prostatitis/CPPS: There are a few types of prostatitis that are caused by infection, but chronic prostatitis is a condition that causes pelvic pain even without the presence of an infection.

Despite it not being caused by an infection, its symptoms often cause the condition to be misdiagnosed as one. This condition can create significant pelvic pain, as well as urinary problems and pelvic floor dysfunction.

Common Infections of the Pelvis

Urinary Tract Infections: UTIs are common infections that can occur in any part of the urinary system. They cause inflammation and pain in the pelvis or back. Recurrent UTIs can create tight pelvic floor muscles, chronic pain, and urinary dysfunction.

Pelvic Inflammatory Disease: This condition is an infection of one or more parts of the reproductive system (uterus, vagina, fallopian tubes, and so on). It can cause painful and irregular menstruation, as well as painful urination.

Chronic PID can create inflammation, adhesions, scarring, and other symptoms that may contribute to pelvic floor dysfunction.

Chronic Yeast Infections: Frequent vaginal yeast infections can create irritation, pain, and sexual dysfunction. Experiencing recurrent yeast infections long-term can create inflammation, hypersensitivity, and pain in the pelvic floor.  

Chronic Fungal Infections: Persistent or recurrent fungal infections such as tinea cruris (also called jock itch) can create pain, irritation, and tension in the pelvic floor. 

Vulvovaginal Infections: Chronic bacterial or fungal infections in the genitalia can create pain, irritation, inflammation, sexual dysfunction, and hypersensitivity—all of which may contribute to pelvic floor dysfunction.

Post-Surgical Infections: Infections that occur as a result of surgeries such as hernia repair or hysterectomy can cause tissue scarring, adhesions, and lasting pain that may contribute to pelvic floor dysfunction.

Other examples of infections or similar conditions can include:

• Epididymitis
• Bartholinitis
• Perianal abscesses
• Pelvic osteomyelitis
• Chronic diverticulitis
• And more

Symptoms Without an Infection

In some cases, you may not even have an infection, yet still experience many symptoms indicative of an infection.

For example, say you undergo testing for a urinary tract infection, receive negative results, yet still experience symptoms like painful urination, back pain, and urinary urgency.

You may find that medications typically used for infections are ineffective, and you experience no relief from your symptoms.

In cases like this (which isn’t limited to urinary infections) it is very important to consider seeing a pelvic floor professional, as many infection-related symptoms mimic pelvic floor dysfunction.

Your condition may not be an infection at all, but a problem with your pelvic floor muscles. Some common symptoms of pelvic floor dysfunction to look out for include:

• Pain in any part of the pelvis or genitals
• Sexual dysfunction (painful sex, erectile dysfunction, etc.)
• Bowel dysfunction (constipation, diarrhea, pain, etc.)
• Urinary dysfunction (frequent urination, urinary urgency, incontinence, etc.)

As discussed before, those who do experience chronic infections can still benefit from pelvic floor physical therapy, which we’ll cover next!

Pelvic floor physical therapy can play an important role in the management of the symptoms caused by chronic infections.

While pelvic floor therapists do not diagnose infections nor directly treat them, the treatments these professionals provide can be extremely beneficial for those who suffer from the long-term effects of chronic infections.

As mentioned earlier, chronic infections can lead to pelvic floor dysfunction due to the creation of muscle tension, scarring, or adhesions. Pelvic floor dysfunction can worsen your symptoms of infection and other chronic conditions.

What started out as a stubborn infection can turn into new problems with bladder, bowel, or sexual dysfunctions, muscle imbalances, lower back pain, pelvic pain, and more.

Your physical therapist can address these issues and even identify any aspects of your health that may contribute to your risk of infection.

The goal of pelvic floor physical therapy for those who have chronic infections or other conditions is to reduce pain, improve muscle health, and restore function.

These physical therapy treatments will improve your comfort and quality of life while you also engage in other treatments that directly target the infection itself.

Your physical therapist will begin with a thorough evaluation, which will include a discussion of your symptoms and medical history, as well as a physical examination.

They’ll evaluate your pelvic health and look for things like trigger points, muscle weakness or tightness, imbalances, tenderness, or pain. They’ll also examine your posture, flexibility, range of motion, and any relevant scar tissue—all of which affect pelvic health.

With the results of your evaluation in mind, your physical therapist will curate a treatment plan for your unique needs. This plan may include a variety of treatment methods based on your individual condition, such as the following examples:

Pain Management

Chronic infections can cause significant pain, not just from the infection itself, but also from pain guarding, which is a natural response to pain. Long-term pain can make you tense your muscles repeatedly and even unknowingly.

This creates muscle imbalances, tightness, and pain. Rest assured that the physical therapists at Hive Therapy and Wellness can address this pain through a variety of treatments!

While addressing your muscle imbalances and other root causes of pain, your physical therapist can also provide a variety of pain-relieving treatments such as manual therapy.

Manual therapy involves physical techniques that manipulate the muscles, nerves, ligaments, and other underlying tissues. These techniques can release trigger points, relieve tight muscles, and improve tissue mobility.

Manual therapy also offers other benefits. For example, it is very effective at mobilizing scar tissue and reducing nerve irritation.

For those experiencing worsened pain from adhesions or scar tissue, manual therapy can be extremely beneficial! In other cases, manual therapy can involve tools such as dilators, which are very useful for individuals experiencing sexual dysfunction and pain.

Dilators are tools of varying sizes that can be used to address tissue tightness of the vagina or rectum. These tools can help reduce tension and pain in these areas, as well as address problems with hypersensitivity.

Pelvic Floor Training

One major treatment necessary for addressing pelvic pain and dysfunction is pelvic floor training. As mentioned before, many chronic infections like UTIs or PID can cause pelvic floor dysfunction.

To address this, your physical therapist will identify areas of tightness, weakness, or inflexibility in your pelvic floor muscles. After evaluating your pelvic health, they’ll utilize a variety of treatments to improve your muscle coordination and function.

These treatments can include biofeedback and neuromuscular education, strengthening exercises, relaxation practice, and specialized exercises to coordinate your pelvic floor with your core muscle groups.

Engaging in these treatments will help relieve tension, strengthen your muscles, and restore function. With consistent treatment, you will experience relief from bladder, bowel, and sexual dysfunctions, as well as reduced pain from chronic infections.

Behavioral Modifications

To further reduce pain and dysfunction, your physical therapist will identify any habits or behaviors that could exacerbate your chronic infections and muscle tension.

Aspects such as poor posture, diet, toilet habits, and more can increase pressure onto your pelvis and worsen muscle tension. As this muscle tension builds, it can exacerbate your pelvic floor dysfunction and pain from chronic infections.

To counteract the effects of these habits, your physical therapist will teach you proper posture, suggest better diet habits, and educate you on healthier toilet mechanics.

Addressing toilet mechanics can help with bladder and bowel dysfunction, such as urgency, frequency, incontinence, and more. Each of these behavioral modifications can reduce tension on the pelvic floor, preventing worsened pain and encouraging better function.

Depending on your unique case, your physical therapist may be able to suggest behavioral modifications or lifestyle changes that can help lessen your risk of future infection.

For example, individuals who experience recurrent UTIs may receive advice on bladder voiding strategies, sexual hygiene, and more.

Core Strengthening and Coordination

For those struggling with persistent infections and pelvic floor dysfunction, it can beneficial to address core dysfunction or weakness.

Chronic infections in the pelvis can not only create tension in the pelvic floor, but also the core, which is closely interconnected with your pelvic floor and other surrounding structures.

When muscle tension and pelvic floor dysfunction are present, the core muscles can become tight and uncoordinated, too.

When the core muscles are not in good health, they can affect your posture, movement, pelvic floor, and muscle function. It can worsen all of these aspects, and increase your pain from chronic infections.

Therefore, during your treatment, you can expect to engage in strengthening and coordination exercises for your core, too.

These treatments will not only balance your muscles, but also improve your flexibility and range of motion through activities such as stretching. Your physical therapist will likely integrate breathing strategies and postural corrections into your core exercises as well, for a more holistic treatment experience!

Education and Maintenance

Physical therapists are experts of the body, meaning they can provide you with a huge wealth of information—how chronic infections impact your pelvic floor, what causes pelvic floor dysfunction, advice for maintaining better posture, and strategies for reducing further strain on the pelvis.

Your physical therapist will also curate an at-home exercise program to help you maintain good pelvic floor and core health outside of the clinic.

This can include pelvic floor training, core exercises, stress management strategies, and relaxation techniques for you to practice long-term.

To further support long-term health, your physical therapist can collaborate with other professionals such as urologists, gynecologists, and more. This allows your provider to address the physical symptoms of your chronic infections while you also receive treatment to directly treat your condition.

At Hive Therapy and Wellness, there are a variety of treatments your provider may use to address your symptoms.

Each person’s condition and experience with chronic infections can vary, so each and every patient will receive an individualized care plan based on their unique needs.

This care plan can include treatments such as the following:

• Neuromuscular re-education 
• Manual therapy
• Exercise prescription 
• Dry needling 
• Cupping 
• Tissue scraping 
• Behavioral modifications 
• Therapeutic activities 
• Electrical muscle stimulation
• Spinal manipulation 
• Therapeutic modalities 
• Biofeedback