Chronic pelvic pain is a common, yet frustrating condition. Chronic pelvic pain refers to any pain in your pelvic region — the area below your bellybutton and between your hips — that lasts six months or longer. Determining what is causing the discomfort can be a difficult endeavor. Sixty-one percent of women who experience chronic pelvic pain never receive a specific diagnosis. Physical therapists at The Nebraska Medical Center Pain Management Program have special training in evaluation and treatment of pelvic pain and other pelvic floor dysfunctions. We can help determine the cause of the pain and provide the therapy to relieve it.
The pelvic floor muscles are located at the bottom of the pelvis and act as a muscular shelf that supports the internal organs and controls the openings to the bladder, vagina and rectum. They contract to prevent leakage of urine or stool during our daily activities, but relax to allow emptying of the bowel and bladder at other times. Also, these muscles may go unrecognized as a cause or contributor to pelvic pain in men and women.
Physical therapists are known for their skills in evaluation and treatment of musculoskeletal dysfunction. Physical therapists at The Nebraska Medical Center Pain Management Program have special training in evaluation and treatment of pelvic pain and other pelvic floor dysfunctions. A physical therapy evaluation for pelvic floor dysfunction consists of taking a complete medical history from the patient, a physical examination of the muscles of the abdomen and pelvis, and a biomechanical assessment of the pelvis and overall body posture. In addition, a vaginal or rectal examination may be performed to determine how well the pelvic floor muscles are functioning, to assess for possible muscle weakness or muscle spasm contributing to each patient’s symptoms.
Evaluation and treatment plan
The evaluation and treatment plan are tailored to each patient’s goals and specific treatment needs. Care is provided in a private, relaxed setting, with comfortable treatment rooms and individual bathrooms and changing areas.
A standard course of treatment in physical therapy for pelvic floor dysfunction takes about six to eight weeks to complete. Most patients are seen in physical therapy about once per week for an hour, but schedules vary greatly based on each patient’s home and work demands. Most work schedules can be accommodated in physical therapy with either early morning or afternoon appointments.
Almost all insurance companies provide coverage for this type of physical therapy, but our clinic staff verifies each patient’s insurance coverage and will do their best to inform each patient if insurance does not cover certain aspects of treatment.
Types of treatment
To treat pelvic pain and musculoskeletal dysfunctions of the pelvis, such as urinary incontinence or chronic constipation, the physical therapy staff will often use neuromuscular reeducation exercises for the muscles of the pelvis, including, but not limited to Kegel exercises for the pelvic floor muscles. Computer equipment and electrodes which are placed on the outside of the body to read muscle activity are used to give patients feedback about their muscle activity. The patient will see their muscle activity on a computer screen while they exercise so that they can work to improve their muscle strength, relaxation and overall coordination with assistance from the computer. Other treatment techniques may include postural correction, myofascial release and manual therapies.
