In very simple terms, pelvic pain is discomfort or pain felt in the pelvic area or nearby areas (such as the lower abdomen, hips, inner thighs, etc.).

This pain can vary widely, and when it comes to communicating with your provider, you’ll want to be able to accurately describe your pain. So, let’s look at the different types of pelvic pain.

You can refer to pelvic pain in four ways:

• acute 
• subacute
• chronic/persistent 
• intermittent/sporadic

Pelvic pain is commonly described as “acute” or “chronic.” Patients and medical professionals often use “pelvic pain” and “chronic pelvic pain” interchangeably—however, in order to ensure you receive proper care, it is essential to describe your pain accurately.

So, let’s look at the four types a bit closer:

Acute: Acute pelvic pain describes short-term pain that is often localized to one area, and typically lasts less than three months. Although it may not last very long, acute pain can be sudden, with symptoms that appear quickly.

In many cases, acute pelvic pain may be felt in reaction to injury, surgery, or trauma—but every case is different. Acute pelvic pain is often felt close to the lower abdomen and is described to be a sharp pain.

Chronic: “Chronic” refers to a condition that is long-term or persistent, often becoming a daily struggle for individuals.

It may require a different level of care than non-chronic pelvic pain. “Chronic pelvic pain” is more accurate when describing long-lasting (longer than 6 months), recurrent, or severe pain. 

In some cases, the cause of chronic pelvic pain can be difficult to pinpoint. It can often be pain that occurs again from an injury or surgery that’s already healed, or may be related to other conditions.

Additionally, chronic pelvic pain may be less concentrated, and may refer to other areas of the body, such as the lower back.

Subacute: Subacute pain is a descriptor that may not be used by all healthcare providers—however, it refers to pain that does not last as long as chronic pelvic pain, but lasts longer than what would be defined as acute.

It is an in-between descriptor for pain that may not strictly fit into “acute” or “chronic” pain. Subacute pain can be dull or sharp, and doesn’t necessarily have to be more severe than acute pain to be considered subacute—it just lasts longer.

Intermittent/sporadic: Pelvic pain can be felt differently depending on the individual case. It can be constant, recurrent (occurring often or frequently), intermittent (comes and goes), or even sporadic (occurring at random).

The severity of the pain can range anywhere from mild to severe. The pain can be described as sharp and stabbing, or dull and achy. In some cases, the pain may only be felt with certain movements or positions.

Now that you have learned some descriptors for pelvic pain, we’ll take a look at some common causes next!

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Pelvic pain can originate from a very wide range of sources. Many different conditions can contribute to pelvic pain, and can vary greatly depending on the person.

In some cases, these conditions can vary based on the reproductive organs you were born with, and can also affect transgender individuals who undergo genital reconstruction surgery or other therapies such as hormone replacement therapy.

The physical therapists at Hive Therapy and Wellness are familiar with all body types, and are able to help people of all gender identities to pursue better pelvic health.

With that being said, here are some conditions that may contribute to symptoms of pelvic pain, organized by type:

Reproductive: 

• Endometriosis: A condition where a tissue similar to the lining of the uterus grows outside of the uterus.
• Pelvic inflammatory disease: A bacterial infection affecting the uterus, fallopian tubes, and ovaries.
• Menstrual cramps: Pain and discomfort associated with menstruation.
• Fibroids: Non-cancerous growths in the uterus.
• Adenomyosis: A condition where the uterine lining grows into the muscle wall of the uterus.
• Ovarian cysts: Fluid-filled sacs on the ovaries, which can become large and painful.
• Chronic Prostatitis or Chronic Pelvic Pain Syndrome: A condition that causes pain or pressure in the pelvic region, and can also affect other aspects such as urination, ejaculation, or sexual function.

Urinary:

• UTI: An infection of any portion of the urinary tract. This infection is more common for those with a vagina.
• Interstitial cystitis: A chronic bladder condition that can cause pain in both the bladder and pelvic area.

Gastrointestinal:

• Irritable bowel syndrome: A chronic condition affecting the gastrointestinal tract.
• Inflammatory bowel disease: A chronic disease causing inflammation of the gastrointestinal tract.
• Chronic constipation: Long-lasting and persistent constipation.

Musculoskeletal: 

• Pelvic floor dysfunction: A condition where the pelvic floor muscles cannot function optimally due to tightness, weakness, inflexibility, or a lack of coordination.
• Myofascial pain: Tension and tightness in the muscles near or in the pelvis can create pain.
• Pain following surgery: Can be caused by nerve damage, adhesions, or painful scars.
• Hernias: An occurrence where tissue pushes through either the abdominal muscles or the connective tissue of the abdomen or groin.

Nerve-related: 

• Nerve entrapment: Occurs when nerves in the pelvis become compressed or irritated.
• Pudendal neuralgia: Compression or irritation of the pudendal nerve, which is in charge of providing sensation to the pelvic region.
• Peripheral neuropathy: Nerve damage caused by a variety of factors that can also affect the pelvis.

Psychological, Neurological, and Emotional:

• Central sensitization: Occurs when the nervous system becomes overly sensitive and amplifies pain signals. Can cause pain even when there is no actual damage to pelvic tissue.
• Stress
• Anxiety
• Trauma

Regardless of the source of the pain, pelvic pain can significantly impact a person’s quality of life. Luckily, there are treatments out there to help you manage your symptoms, including pelvic floor physical therapy.

Your pelvic floor physical therapist is aware of the many different causes of pelvic pain.

They’ll be able to work with you, your medical history, your symptoms, and any present conditions you may have to create a management or treatment plan that works for your unique needs.

Some possible treatments may include the following:

Pain Management: Physical therapists can offer a variety of pain-relieving treatments, such as heat or cold therapy, dry needling, cupping, and more. These can help provide quick relief as well as provide long-term pain management for those with chronic conditions.

Pelvic Floor Muscle Training: With any level of pain, muscle tension may follow. The pelvic floor is susceptible to muscle tension—meaning pelvic floor dysfunction is likely among any condition that causes pelvic pain.

Pelvic floor dysfunction can worsen pelvic pain symptoms and even add additional symptoms, so it’s essential that your physical therapist addresses your pelvic floor health.

Manual Therapy: Manual techniques can help reduce muscle tension, relieve trigger points, and reduce muscle spasms that can contribute to pelvic pain.

Manual techniques to address pelvic pain can be applied in a variety of ways: internally via the vagina or rectum, or externally via the pelvis, abdomen, hips, back, and other parts of the body.

Behavioral Modifications: Your physical therapist may help suggest lifestyle changes and fix behaviors that may contribute to or worsen your pelvic pain, such as poor standing or sitting posture, and other habits that may be causing pelvic floor dysfunction.

Neuromuscular Re-education: This treatment helps retrain the nervous system to engage, relax, or respond to stimuli correctly. It can be utilized for pain sensitivity, such as with central sensitization. 

Exercise Prescription: Your physical therapist will curate an exercise plan to help target a variety of areas of the body. This can include the core, hips, and lower back to improve balance and reduce pressure from the pelvic floor.

They’ll also walk you through exercises for the pelvic floor, especially in the case that those muscles are weak and not able to function properly.

Relaxation techniques: Pelvic pain, especially chronic pelvic pain, can understandably cause a lot of stress and anxiety. Your physical therapist can teach you effective relaxation techniques such as deep breathing to help you reduce tension and control stress during flare-ups.

The physical therapists at Hive Therapy and Wellness take a very holistic approach to treatment. They are very familiar and experienced with educating their patients and helping them better understand their bodies.

When working with Hive’s physical therapists, you can be assured that they genuinely care for your wellbeing and work hard to help you achieve long-term results!

To provide relief for pelvic pain, the physical therapists at Hive may use any of the following treatment methods:

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