Updated: Oct 4, 2022
Chronic pelvic pain is defined by pain below your belly button and between your hips that lasts 6 months or longer. Sometimes, even with a lot of testing, the cause of pelvic pain remains a mystery. That does not mean that there is not a cause. Pelvic health physical therapists are the experts in the joints, muscles and nerves that could be playing a role in your pain. Just like you can get a headache from tension in your neck and shoulders, you can get a "headache in the pelvis" from tension in the pelvis.
Symptoms range from
- mild to severe
- coming and going to all the time
- pain during sex
- pain with certain positions or movements
- pain when you urinate or have a bowel movement
- painful periods
- dull pain, sharp pain or radiating pain
Many men and women will undergo tests such as ultrasounds, CTs or MRIs or even laproscopic surgeries and still not understand the cause of their pain. That is where pelvic floor physical therapists come into the picture. Our job is to find the muscle or joints that may be contributing to the issue.
Photobiomodulaton therapy or class IV laser has been shown to treat muscle spasm & pain and nerve pain. Hundreds of published studies have documented the benefits of laser on sprains and strains, post-surgical pain, whiplash, muscular back pain, radiculopathy, tendinitis, osteoarthritis and neck and back pain, plantar fasciitis, chronic regional pain syndrome and neuropathic pains like diabetic neuropathy and trigeminal neuralgia. But what about “pain down there?”
Class IV laser has been shown to help muscle spasm and pain and pain arising from nerves elsewhere in the body. A study of low-level laser therapy for provoked vestibulodynia found 78% of patients receiving laser reported improvement compared to 44% of controls. There were no side-effects in the laser group. We also often use laser with scars to reduce pain and promote healing.
Our approach is head-to-toe and seeks to find the root cause of the pain. Some of the other approaches we have are:
A thorough exam: Pelvic pain can originate from the spine, sacrum, sacroiliac joints or hips. Your nerves can be involved and hormones can affect your tissues. We do a full and thorough exam to figure out the root cause and contributors.
We use manual therapy or hands-on treatment. You will never be left alone in a room with a machine or with a tech
Nutrition & Lifestyle
When our gut health is poor, we have more inflammation in our whole body. The inflammation acts to increase the amount of immune activity and may make our tissues more sensitive.
Chew your food 40x prior to swallowing (this helps your stomach work properly, which helps your small intestine absorb nutrients properly)
In order to properly digest and absorb nutrients, you need to have relaxation and be in the parasympathetic nervous system mode (rest, digest, procreate)
At RVA Holistic PT, if you have “pain down there” or painful sex, we offer an integrated approach including helping your spine and pelvis orthopedically, alignment, breathing, mindfulness and pelvic floor muscle relaxation. If “pain down there” is caused by muscle spasm/ pain or neuroproliferation, laser is a wonderful “extra” boost. Many of our patients have had excellent success with laser treatment (integrated with all the other wonderful things we do).
One thing is for certain, there needs to be much more research in the field of pelvic pain. All-in-all 14% of women are estimated to have chronic pelvic pain. Of those, 60-85% of women with CPP have pain in their pelvic floor muscles, which is why physical therapy is advocated as a first-line treatment for provoked vestibulodynia (Morin). If you are in the Richmond, Virginia area and are interested in an integrative approach to pelvic pain-- including class IV laser -- you can book with us for a clinic visit.
Lev-Sagie, Ahinoam, Asia Kopitman, and Amnon Brzezinski. “Low-Level Laser Therapy for the Treatment of Provoked Vestibulodynia—A Randomized, Placebo-Controlled Pilot Trial.” Journal of sexual medicine 14.11 (2017): 1403–1411. Web.
Morin, Mélanie et al. “Multimodal Physical Therapy Versus Topical Lidocaine for Provoked Vestibulodynia: a Multicenter, Randomized Trial.” American journal of obstetrics and gynecology 224.2 (2021): 189.e1–189.e12. Web.
Zipper, Ralph, and Brian Pryor. “Evaluation of a Novel Deep Tissue Transvaginal Near-Infrared Laser and Applicator in an Ovine Model.” Lasers in medical science (2021): n. pag. Web.