Persistent Pelvic Pain in Women-Holistic Healing From the Inside Out

Are you living with persistent/chronic pelvic pain?  You are not alone; in the US roughly 15% of women are affected by chronic pelvic pain.  Chronic pelvic pain is pain in the lower abdomen or pelvis that lasts for 6 months or longer. Several conditions are associated with pelvic pain, including:  endometriosis, interstitial cystitis, vulvodynia, vaginismus, sacroiliac joint pain, urinary urgency, constipation, IBS, uterine fibroids, PCOS, and many more. You may have been to a doctor who ran several tests that came back negative, so they sent you on your way telling you that they aren’t sure why your pain is persisting.   

It is easy to assume that if your pelvic organs are healthy, the pain should go away.  However, many things can contribute to persistent pain in the pelvic region.  A few things that contribute are: tension in the pelvic floor, lack of coordination of the pelvic floor, tight or weak hip muscles, injury or pain in your ankles or knees, your feet, restricted breathing patterns, tissue restrictions from an old or new abdominal scar, injury or pain in your lower back or hips, constipation, frequent urination, restricted movement in your mid back, core weakness and tension. 

I think you get the idea; pain in the pelvis is affected by just about all of the other parts of your body. It is important to have a thorough evaluation by a pelvic PT to address these things, so that your body can function more optimally,ultimately improving your pain. Please do not just do kegels;  your pelvic floor may already be too tense and this may make your symptoms worse.  In addition, if the other areas of your body (hips, knees, etc) are not addressed, the pelvic floor will continue to compensate, and your pain will persist. 

Your emotions, stress, and anxiety also play a huge role in chronic pelvic pain.   As a woman, you have most likely walked around with your belly tight, your breath restricted, trying to please everyone, while attempting to be a perfect wife, mother, daughter,etc.  Perhaps you experienced trauma as a child, or were sexually assaulted as a teen/adult.  Your body tells a story, and you can store a lot of unprocessed emotion in the area of the pelvis. Overall, the pelvic floor tries to protect us, and responds to the overall state of our nervous system. 

 Experts agree that pain can occur without any actual injury to tissue. The current definition of pain is: an unpleasant sensory and emotional experience associated with actual or potential tissue damage.  Now, I want to be clear; If you are living with chronic pain,I am not saying the pain is not real.  However, pain is complex.  The nervous system acts like an alarm system when it comes to pain; pain is a warning signal.  It is important to feel pain when there is injury to your tissues, so that you can tend to it and do all the right things to expedite the healing process.  If you ignore early signs (the gentle nudges), then the body feels like it needs to scream to get your attention. This is analogous to a toddler who starts off gently saying “mom” and when you tell them to wait a minute, the intensity rises “MOM”!!! Your NS becomes more sensitive the longer you are in pain, which means that even after the tissue has healed, your nervous system continues to sense a threat. 

Have you ever noticed that your pain is worse when you are stressed out?  This is because the nerves that travel to the spinal cord respond quicker and with a higher intensity when your nervous system is on high alert..  If this were a home alarm system you installed in your house, you would want it to go off when someone was trying to break in, but you would not want the alarm to go off when a leaf blows by.  Once again, the pain is real, but your nervous system may be overprotecting you. 

This being said, one of the most important things to do when you are living with persistent pelvic pain is to tend to your nervous system.  One thing you can experiment with, is to notice how you respond to unpleasant sensations in your body.  When you panic or worry, the nervous system feels like it has to protect you and amplifies the pain. What if you were to notice a sensation with curiosity?   Your body is amazingly resilient when it feels safe, and when it is working in optimal alignment mentally and physically. 

After hearing this, most people ask me “So what can I do about it?” Here are a few ways that  you can get started in working towards improving your pain and returning to the activities that you love:

• Breathe…… Breathe in and feel your belly and rib cage expand; allow your ribs to expand not only on the front of your body, but the sides and back too.  When we breathe efficiently the pelvic floor can do its job more effectively.  For some people, breathwork can feel triggering.   If this is the case for you, movement may be a better place to start. 

  
  

• Experiment with relaxing your belly, relaxing the muscles in the bowl of your pelvis. If relaxing these muscles seems impossible, don’t give up!  The muscles may just take some time to remember what letting go of tension feels like. 

  
  

• Practice some form of mindfulness:  mindful breathing, body scan, mindful walking, mindful eating, yoga (mindful movement), and connecting with nature. Be patient with yourself; if your nervous system has been in fight or flight for a while, this will not be easy.  Please know that these practices are not something to be good at, just to practice. Think of it like going to the gym for your nervous system; it will take time. 

  
  

• Notice your response to an unpleasant sensation in your body.  Do you start to worry or tense your muscles?  What would it be like to be curious and explore the sensation in a non judgemental way?

  
  

• Connect with a pelvic floor PT.  We can evaluate not only the PF, but your abdomen, old scars and myofascial restrictions, hip flexibility and strength, your feet and ankles, old injuries that may be causing you to compensate, etc.  Once we have more information, then we can work on increasing flexibility, strength, breath efficiency, reduce the nervous system’s overprotection, and help you remember your body’s natural resilience and healing potential. We can also work on strategies to reduce straining with bowel movements, help with urinary urgency and incontinence, help you return to activities after a vaginal or cesarean birth, and help you as you heal from a hysterectomy.  Most importantly, we can help reduce your pain and get you back to the activities that you enjoy in a safe and gradual way. 

  
  

• Connect with your chiropractor to improve optimal alignment.  When all the parts are lined up, your body systems can all work more efficiently.  

  
  

• Connect with your acupuncturist to soothe your NS, reduce pain, and bring balance to your body systems.

  
  

• Connect with your massage therapist to reduce tension in your muscles and fascia. 

  
  

• Connect with your mental health counselor to help you discover the stories that may be stored in your pelvis and release what you are ready to let go of. 

  
  

• Move your body:  walk, swim, dance; whatever feels good for your body and makes you smile!

  
  

• Trust yourself, and trust your body.  Be patient, kind and compassionate towards yourself.  Treat yourself with the same love and kindness that you do for your children, loved ones and friends.   

  
  

• Remember that you are more than just an injured body.  Who you are is whole.  Sometimes we just forget and zoom in on the things that are “wrong”.  Open up to the essence of who you are; a strong, beautiful, perfectly imperfect human!  

Disclaimer:  This article is for general information only and does not take the place of professional medical advice.  FT

-Michelle Walz

MPT, CYT

Integrative Healing and Life Coach