Pelvic Pain
Treatment

Treatment for chronic pelvic pain is tailored to each patient, depending on the underlying causes of the pain. Some treatment options include:

• Hormones for conditions such as endometriosis or heavy menstrual bleeding.
• Pain medications such as narcotics, nonsteroidal anti-inflammatories or medicines for nerve pain.
• Surgery for some women with adhesions, adenomyosis or endometriosis.
• Physical therapy and biofeedback for women with myofascial (connective tissue) or muscle pain.
• Psychological therapy, medication, or both to help you cope with chronic pain. A therapist can offer support and tools to handle living with chronic pain, and can also help you and your partner cope with the relationship and sexual issues that can arise as a result of chronic pain.
• Mind/body techniques such as meditation, breathwork, guided imagery and yoga. For example, try this short guided imagery exercise (audio only).
• Nutrition and supplements — for instance, a diet rich in fruits, vegetables and grains is important. Avoiding foods that can increase inflammation and increasing foods that decrease inflammation can be useful.
• Alternative healing systems such as traditional Chinese medicine, which have been found to help relieve pain. We can refer you to an appropriate provider.

Chronic pain is very difficult to deal with. It's important to set reasonable goals and develop a treatment plan that addresses your unique health needs. It's also important to attend to your emotional health, and to focus on what brings joy and meaning to your life.

Physical Therapy

Some studies show physical therapy helps 60 percent of women with chronic pelvic pain and levator ani syndrome. It helps to align bone or muscular imbalances, decrease abnormal muscle tension and soft tissue, and strengthen your core muscles to prevent further injury. A physical therapist can also help identify other factors that may contribute to your pain, such as poor posture, positioning and habits.

During a visit, your physical therapist will conduct a thorough musculoskeletal examination, identifying sources of pain and dysfunction. Sometimes alignment of the feet, hips, and back will affect the posture of the pelvis and perpetuate the pain cycle. A woman who has had chronic pelvic pain long-term may notice she has symptoms in other areas of her body. Patients may notice changes in the muscles, skin and tissue of the pelvis, back and abdomen.

Your physical therapist will examine the muscles of the pelvic floor as well as the abdomen, thighs and back. The therapist will work with you to develop a treatment plan to address your specific issues and goals.

Physical therapy techniques for disorders of the joints and soft tissues of the pelvis may include education, internal and external myofascial release, manual therapy, therapeutic exercise, and treatments such as electrical stimulation or biofeedback. You may also use tools for self treatment at home, such as dilators and a product called Crystal Wand. A home program is also a vital component of physical therapy, maintaining and improving the musculoskeletal changes we make in the clinic.

Reviewed by health care specialists at UCSF Medical Center.
Last updated May 23, 2012