Get pelvic pain relief with PT

There are a variety of reasons why a woman might have pelvic pain, or pain in the region below the belly button. Whether it’s pain during menstruation or sex, or when using the bathroom or lifting something heavy, pelvic pain can be dull or sharp, constant or sporadic. It can also be so severe that it affects a woman’s ability to perform daily activities, such as working, socializing, exercising and having intercourse.

According to the National Institutes of Health (NIH), pelvic pain is usually a sign of a problem within one or more of the organs in the pelvic area, including the uterus, vagina, intestine or bladder. This can include infection, inflammation or conditions such as irritable bowel syndrome (IBS), uterine fibroids or endometriosis.

Treating pelvic pain

While treatment depends on the cause and severity of pelvic pain, there are common approaches to relieving pain. They include medications, hormonal treatments, surgery and lifestyle changes. Lisa Prieto, a physical therapist at the Sharp Allison deRose Rehabilitation Center, says pelvic physical therapy (PT) can also be effective at relieving pelvic pain.

“We use a variety of techniques in PT to treat pelvic pain that may include diaphragmatic breathing, guided imagery, pelvic muscle relaxation — sometimes known as reverse Kegels — therapeutic exercise, manual techniques and biofeedback,” Prieto says. “Often, we start with learning to relax your pelvic floor.”

She explains three of these methods:

Diaphragmatic breathing — also called deep, belly or abdominal breathing — uses the diaphragm to help you slow and deepen your breathing. As you breathe deeply, the diaphragm and pelvic floor lower. Diaphragmatic breathing can help you to feel calm and relaxed. Studies have found that slow, deep breathing can also help in the perception and management of pain.

Guided imagery — also known as visualization — can also help relieve pain and stress by lowering the body’s levels of stress hormones, such as cortisol. During guided imagery, you visualize a comforting scene and focus on what you see, hear, taste, touch, smell, think and feel. Your thoughts move away from the pain you might be feeling to pleasant sensations, resetting your hormone levels and decreasing inflammation.

Reverse Kegels involve consciously relaxing the pelvic floor muscles you use to control the flow of urine instead of tightening them, as you would during a Kegel exercise. Learning to relax the pelvic area can result in pain reduction. During reverse Kegels, you use can diaphragmatic breathing and visualization to imagine you’re releasing the tension and pain in your pelvic area as you lengthen the muscles between your tail bone and pubic bone.

Additionally, a vaginal dilator, a tube-shaped medical device used to stretch the vaginal tissues, can help prepare your body for pain-free intercourse. The NIH reports dilators are usually made of medical grade plastic or silicone, and may come individually or in sets. Some have special features, such as vibration or the ability to be heated or cooled before use.

“Using a vaginal dilator is something someone may work on as part of their home program,” Prieto says. “They would start with the smallest one and progress through to the larger sizes, working on relaxing the muscles as it is inserted.”

Talk with your doctor to see if you would benefit from working with a pelvic physical therapist. “A pelvic physical therapist can assess what exactly is going on with your pelvic floor muscles and make recommendations for what you can do to relieve your pain,” Prieto says.

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