Everything You Need to Know About Pelvic Pain

It’s a dull ache low in your belly that never quite goes away, a sharp pain with intercourse, or a pressure in your pelvis that gets worse the longer you sit. You’ve been told your tests are “normal,” yet it still hurts. Pelvic pain is complex and often misunderstood. It affects both men and women, and it can affect work, relationships, sleep and mood.

Here’s what pelvic pain is, its most common causes and symptoms, the warning signs that need a doctor right away, how it is diagnosed, and how pelvic health physical therapy helps.

What Is Pelvic Pain?

Pelvic pain is discomfort or pain in the lower abdomen, in the area below the belly button and between the hips. It can be mild or severe, and it can be acute (new) or chronic (lasting months). There are three broad types:

• Musculoskeletal pelvic pain: comes from the muscles, joints and ligaments, such as muscle imbalances, joint dysfunction or ligament strain. Poor posture, injury and overuse can all play a part.
• Visceral pelvic pain: comes from the organs in the pelvis, such as the bladder, uterus or intestines. Conditions like irritable bowel syndrome (IBS), endometriosis and interstitial cystitis are examples.
• Neuropathic pelvic pain: comes from irritated or damaged nerves, such as pudendal neuralgia, and often feels shooting or burning.

Common Causes of Pelvic Pain

Pelvic Floor Dysfunction

The pelvic floor is a group of muscles, ligaments and connective tissue that support the organs in the pelvis. When these muscles are too tight, too weak or poorly coordinated, they can cause pelvic pain, urinary or fecal incontinence and sexual pain. Common triggers include childbirth, surgery, injury and chronic constipation.

Gynecological Conditions

• Endometriosis: tissue similar to the lining of the uterus grows outside the uterus, often causing severe pain around menstruation
• Fibroids: noncancerous growths in the uterus that can cause pelvic pain, heavy periods and pain with intercourse
• Pelvic inflammatory disease (PID): an infection of the female reproductive organs, often caused by a sexually transmitted infection

Bladder Conditions

• Interstitial cystitis: a chronic bladder condition with frequent urination and pelvic pain
• Urinary tract infections (UTIs): cause lower abdominal pain, urgency and burning. If your symptoms feel like a UTI but your tests keep coming back clear, read when pelvic pain is not a UTI but feels like one.

Bowel Conditions

Irritable bowel syndrome (IBS) is a common digestive disorder that causes abdominal pain, bloating and changes in bowel habits, often with pelvic discomfort.

Joint and Muscle Problems

Sacroiliac (SI) joint dysfunction, where the joint that connects the spine to the pelvis becomes irritated or doesn’t move well, can cause both lower back and pelvic pain. Learn more about SI joint pain.

Symptoms of Pelvic Pain

• Chronic or recurring pain: a dull, aching or sharp pain in the lower abdomen or pelvis
• Pain with intercourse: known as dyspareunia. See pelvic therapy for painful intercourse.
• Bladder symptoms: frequent urination, urgency, or pain when you urinate
• Bowel symptoms: constipation, diarrhea, bloating or other changes in bowel habits
• Menstrual changes: pain that follows your cycle, or irregular cycles
• Emotional impact: chronic pelvic pain can lead to stress, anxiety and depression because of how much it affects daily life

When to See a Doctor Right Away

• Sudden, severe pain: especially with fever, vomiting or fainting
• Pain during pregnancy: or pain with a possible pregnancy
• Heavy or unusual bleeding: or blood in your urine or stool
• Fever with pelvic pain: or unusual discharge
• New loss of bladder or bowel control: or numbness in the groin

How Pelvic Pain Is Diagnosed

Because pelvic pain has so many possible causes, diagnosis often involves more than one provider. Depending on your symptoms, your healthcare team may use:

• Your history: a detailed discussion of your symptoms and health history
• A physical exam: including a pelvic exam to check for tenderness or other changes
• Imaging: such as ultrasound, CT or MRI
• Lab tests: blood tests and cultures to rule out infection
• Laparoscopy: a procedure to look inside the pelvis, often used to diagnose endometriosis
• Nerve testing: such as nerve conduction studies or EMG when nerve pain is suspected

Treatment Options for Pelvic Pain

• Pelvic floor physical therapy: to relax, strengthen and coordinate the pelvic floor muscles and fix the muscle imbalances around the pelvis
• Medications: such as pain relievers, muscle relaxants or antibiotics, depending on the cause
• Lifestyle changes: diet changes, stress management and posture exercises
• Surgery: for some conditions, like severe endometriosis or fibroids
• Nerve blocks or injections: for some types of nerve pain

How Pelvic Health Physical Therapy Helps

When muscles, joints or nerves are part of the problem, pelvic floor physical therapy is often the missing piece. At Back In Motion Physical Therapy & Performance, our pelvic floor physical therapy uses The Gray Method™ to look at the whole picture, from your pelvic floor to your hips, lower back, breathing and posture. Treatment may include hands-on work to release tight muscles, exercises to relax or strengthen the pelvic floor, and changes to the daily habits that keep the pain going. Read how pelvic floor physical therapy can change your life.

Ways to Help Prevent Pelvic Pain

1. Mind your posture: good posture reduces strain on the pelvic muscles and joints.
2. Stay active: regular exercise, including core strengthening, supports the pelvis.
3. Practice safe sex: lowering the risk of STIs lowers the risk of pelvic inflammatory disease.
4. Manage chronic conditions: keeping conditions like IBS or endometriosis under control can reduce flare-ups.
5. Get checked early: seeing a pelvic health specialist early helps catch problems before they become chronic.

You Don’t Have to Live With Pelvic Pain

Pelvic pain is complex, but with the right evaluation and treatment, most people can feel much better. Our pelvic pain physical therapy in Fort Myers starts with The Gray Method™, one-on-one with a Doctor of Physical Therapy at our clinics in Fort Myers, Cape Coral and Estero.

Start with our Fixing the Cause & Not Just the Symptoms Assessment, or Inquire About an Appointment →

Call our office at (239) 223-0484 to schedule your appointment.