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Physical Therapy for Pelvic Pain - by Lyne Stewart, P.T., LMT

Is back pain limiting your activity?  Do you have sexual pain?  Is your social life limited because of bladder cramping?   Pain disorders associated with the muscles of the pelvis (Pelvic Floor Dysfunction) or the bladder (Interstitial Cystitis) may be the source of the problem.

The pelvic floor is a muscle group that runs from the pubic bone in front to the tailbone in back.  It acts as the floor of the pelvis, supporting the pelvic floor structures and helping to control continence. The pelvic floor muscles surround the urethra, vagina, and rectum. 

Pain in the bladder can cause spasms in the muscles of the hips, buttocks, low back, abdomen, and pelvic floor (the vaginal area).  The muscle spasms themselves are painful, and in turn, can contribute to joint malalignment in the low back and pelvis.

Your doctor should perform the initial evaluation of your chronic pelvic pain.  Physical therapy is often an effective and conservative option for the treatment of chronic pelvic pain. 

After an evaluation of the muscles and joints of the pelvic floor, buttocks, low back, abdomen and hips, a treatment plan can be devised.  Treatment options may include: biofeedback, trigger point massage, gentle myofascial release, and an individually tailored exercise program.  Every patient is offered choices, privacy, confidentiality, and education on what she can do to help herself. 

 PHYSICAL THERAPY FOR PELVIC PAIN

Myofascial Relaxationa form of massage in which the physical therapist targets a specific muscle or soft tissue.

Joint Mobilizationa very gentle force put on the bone so that the joint can move freely (as in the hips or the back).  This movement helps return the joint to its normal alignment, which decreases pain.

Biofeedbackequipment that detects your muscle activity and displays it on a computer screen.  This allows you to receive visual feedback about your ability to contract and relax the muscle.

Exercisean individualized exercise program will be tailored to your ability level.  Exercise will improve strength, flexibility and functioning of the muscles and joints.

Stress Management and Relaxationtips are given to patients to help them achieve total body relaxation, which helps stop the pain cycle.

TENSa relaxing stimulation of nerves which blocks pain perception.  Patients can use battery operated mobile units that they can wear during their daily activities.

Comfort and self-help measures 

  • Wipe from front to back.

  • Wash your hands before and after wiping your pelvic floor.

  • Take a warm bath with baking soda.

  • Wash your perineum well daily with soap (non-perfumed) or plain water.

  • Avoid sitting in a wet bathing suit.

  • Avoid community baths or Jacuzzis.

  • Avoid douching and vaginal deodorant.

  • Wear loose underclothes and pants.

  • Avoid tampons and diaphragms.

  • Try to empty your bladder completely by sitting for a little longer and relaxing completely.

  • When emptying your bladder keep your back straight. If you have trouble emptying your bladder, you may perform Kegels (pelvic floor contractions) and/or tilt you pelvis back and forth before urinating.

  • Increase your water intake.

  • During sexual intercourse, use lubrication.

  • If you have a strong desire to void but there is not toilet around, try to relax, take a deep breath and do slow Kegel exercises.

  

Lyne Stewart, P.T., LMT

Physical Therapy – Woman’s Health

The Fitness and Therapy Center at

The Woman’s Hospital of Texas

7400 Fannin, Ste 1145

Houston, TX 77054

Phone: 713-799-6125


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All information on the P.U.R.E. H.O.P.E. Web site is provided with the understanding that the P.U.R.E. H.O.P.E. does not engage in the practice of medicine.  The members of P.U.R.E. H.O.P.E. cannot and do not give medical advice.  No information on this Web site should be considered medical advice.  Only your personal physician can do this for you.

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