Frequently Asked Questions

Many physical therapists provide components of the interventions we provide as part of their program. They may or may not be specialists in treating chronic pelvic pain, and often do this as part of a general physical therapy practice. We are experts in treating pelvic pain conditions, and treat pelvic conditions exclusively. We provide a comprehensive evaluation and design a treatment program addressing the root cause of each individual’s condition. Many of our clients come to us having attended extensive physical therapy with one or more practitioners, and having suffered for many years without relief. Our program empowers clients to continue to improve in relatively few visits, through self-administered treatment in the comfort of their own home. We provide a comprehensive consultation which takes into consideration the entire individual, rather than just pelvic symptoms. We work closely with a variety of practitioners to develop a holistic intervention program that helps the individual resume participation in their life roles.

Pain becomes chronic when the cause of the pain is not addressed adequately in a timely fashion. Often patients with pelvic pain are treated for their symptoms, rather than addressing the root of their problem. In many cases pelvic pain is the result of muscle spasm or imbalance of the pelvic floor muscles, regardless of the triggering event. Triggers for pelvic pain may include childbirth and associated conditions, inflammation (of the prostate or seminal vesicles or bladder), hormonal imbalance (menopause), infections (such as urinary tract infection, prostatitis, yeast infection, bacterial infection), trauma, scar tissue restriction, post-radiation or chemotherapy, sports related injuries (cycling, running, intense bodybuilding), stressful life situations, emotional or sexual abuse.

Sitting, driving, sexual activity and participation in exercise are commonly affected. People who suffer from chronic pelvic pain often complain of difficulty concentrating and engaging in social activities.

Emotional impact may include depression, anxiety and feelings of helplessness or hopelessness. Social isolation is common, and personal relationships are often impacted. Participation in work is often limited by this and by physical discomfort. Some people have to stop working while suffering from chronic pelvic pain. Most people report that their sleep is impacted by the condition.

Chronic pelvic pain often goes misdiagnosed as prostatitis, vulvar vestibulitis or infection even when no signs of inflammation are present. While it is important to be evaluated by your physician to make sure that no infection or pathology of the organs are present, many physicians are not familiar with the techniques used to treat the muscles of the pelvic floor. Physicians who are used to treating pathologies of the internal organs may not be consulted regarding musculoskeletal injuries on a daily basis, and may therefore not be familiar with assessments and interventions geared toward these structures.

As long as a patient has had a thorough medical check-up and pathology has been ruled out, our experience has shown that myofascial trigger point release, relaxation, and neuromuscular re-education are effective treatments for pelvic pain and dysfunction

This depends on how long you have had your condition and on its degree of severity. It is generally easier to effect change in a condition which has not become chronic. The average number of visits at our clinic is 6-8, and this is over a 12 month period. Occasional patients require only an initial evaluation/education session or 2 to 3 additional visits. Occasionally patients require 10 to 24 visits in a 12 month period. Our goal is to help our patients understand their condition and learn how to best administer therapy at home. We use our therapy time to administer hands-on work. We pride ourselves on educating our patients and their spouses (or significant others) to administer self-treatment.

It is helpful to send us a “timeline” of your pertinent medical history and results or reports on any tests you may have had prior to your initial consultation. A bladder &/or bowel diarycompleted over 2 days is often helpful.

Therapy will include: Myofascial trigger point release to involved muscles, applied externally and internally (where indicated). Sometimes scar tissue release or visceral mobilization is necessary. Relaxation and stress reduction techniques are taught. Behavioral techniques for healthy bowel, bladder and sexual function are reviewed and a comprehensive exercise program which incorporates stretching, strengthening, neuromuscular re-education and core stabilization is designed. An integral part of therapy includes a postural evaluation, taking into account the patient’s activities of daily living.

Some clients benefit from biofeedback training or electrical stimulation to their pelvic floor muscles: if this is the case, we generally recommend doing this at home with a portable device, and we will teach you how to use it properly for optimal outcomes.

Most of our patients find that soaking for 20 minutes in a warm bath is helpful to relax their muscles and ease discomfort. We advise you to consult with your doctor about the use of medication to help muscle relaxation. Some doctors use such a protocol diagnostically: if the patient feels better on muscle-relaxant medication, the symptoms may be suggestive of a neuromuscular or musculoskeletal problem. A lack of improvement with muscle relaxants does not definitively rule out muscular contribution to any individual’s symptoms. Different individuals respond differently to specific medications, and some individuals respond more positively to mechanical stretching and relaxation techniques than they do to pharmacological intervention.

While a prescription is not necessary to evaluate or to begin treatment, it is a good idea to see your doctor to rule out any pathology of the organs. If you do not have a doctor that you can consult regarding your condition, we would be happy to refer you to an appropriate practitioner. If treatment extends beyond 10 visits or 30 days, which is unusual in our practice, a prescription will be necessary to continue treatment.

We suggest you wear comfortable, loose-fitting clothing. Please bring your completed intake forms, timetable detailing condition from onset to present, any reports or test results, and a prescription from your physician. Bring along some form of exercise clothing.