INTERNAL PELVIC PAIN

For External Pelvic Pain click here

Endometriosis

  • A condition where the cells that line the uterus grow in other parts of the body 

  • Symptoms include painful periods (may be felt in abdomen, back, hips, or in other parts of the body - pain that flares with ovulation, pre-menstrually or during your bleed), painful intercourse, heavy bleeding +/- clots, bladder and bowel symptoms (urgency, hesitancy, constipation), fertility issues

  • Requires a multi-disciplinary approach (including Gp, Pain Specialist, Gynaecologist, Physio)

  • Physiotherapy helps you to manage your pain - including muscle release (internal and external), joint mobilisation around the back and pelvis, exercise programming, pain physiology education, mindfulness, breathwork 

Pudendal Neuralgia 

  • The pudendal nerve follows a windy course from the sacrum (back of the pelvis) to the clitoral area giving off branches along the way

  • Typically experienced as one sided pain/burning/tingling/numbness that is aggravated by sitting

  • Typical causes are cycling, entrapment of the pudendal nerve along it's pathway, post-radiotherapy, post-surgical trauma, polyneuropathy, compression of the nerve from tumour

Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC)

  • Pain associated with bladder filling

  • May also cause urinary urgency and/or frequency and/or nocturia (increased emptying of bladder at night)

  • No infection present

Urethral Pain Syndrome (UPS)

  • Pain associated with passing urine

  • May also cause urinary urgency and/or frequency and nocturia

  • Urethritis is a type of UPS and can be an infective urethritis (e.coli, herpes, chlamydia, gonorrhoea) or an inflammatory urethritis (after catheter removal, following previous infection, chemical sensitivity, oestrogen deficiency) 

Dyspareunia

Painful intercourse secondary to:

  • Tight pelvic floor muscles

  • Low oestrogen levels (when breastfeeding or when peri-/post-menopausal)

  • Endometriosis

  • Cysts/fibroids

  • Mesh protrusion following surgery

  • Birth trauma - perineal tear or episiotomy, internal vaginal wall tear

  • Neural pain (sensitisation, irritation, compression)

  • Vulvodynia/Vestibulodynia 

  • Post-surgical pain/vaginal tightness)

  • Infection (thrush, herpes, bacterial vaginosis, lichen sclerosus, lichen planus)

  • Pelvic inflammatory disease

Vaginismus

  • Tightness of the pelvic floor muscles that can cause difficulties with intercourse, tampon insertion and removal, PAP smears

  • Often, unfortunately, treated as a purely psychological disorder

  • Very treatable with physiotherapy

Vulvodynia/Vestibulitis

  • Pain, burning, or discomfort in the vulva region that cannot be linked to a specific cause 

  • It may or may not be triggered by touch

Anorectal Pain

Dyschezia

  • Pain passing a bowel motion

  • Usually related to other pathologies (anal fissures, haemorrhoids or pain syndromes)

Chronic Proctalgia

  • Ongoing rectal pain or aching lasting >20mins

  • Caused by tightness of one of the pelvic floor muscles (puborectalis)

Proctalgia Fugax

  • Repeated episodes of pain in the anus or rectum lasting a few seconds/minutes with no pain between bouts

  • Can be related to history of chronic constipation

  • May be a spasm of the anal sphincter or puborectalis

Chronic Pelvic Pain (CPP)

This is an umbrella term used for any ongoing internal pelvic pain

Persistent Genital Arousal Syndrome

Not specifically a pain syndrome, but a very uncomfortable constant state of arousal that usually needs multi-disciplinary management (including Physio, Doctor, Specialist)

For External Pelvic Pain click here

At Beaches Pelvic Physio we treat all aspects of the pelvis both internal and external,

together with associated areas of the body.  

We work closely with many Specialists, Therapists and Trainers including: GP’s; Integrative GP's; Sports Physicians; Gynaecologists; Obstetricians; Urologists; Urogynaecologists; Gastroenterologists; Colorectal Surgeons; Nutritionists; Naturopaths; Massage Therapists; Exercise Physiologists; Personal Trainers; Yoga & Pilates Instructors, to achieve the best results for you.

If you are unsure about anything, please don't hesitate to call us on: 0435 150136 or 02 8964 5579.

Alternatively you can email us at: hello@beachespelvic.physio 

or via the contact form

 

For online bookings:

Beaches Pelvic Physio                                             Suite 4219 

Lvl 2, Dee Why Grand Commercial          

834 Pittwater Road

Dee Why NSW 2099                                                               
M: 0435 150136

T/F: 02 8964 5579                                                    E: hello@beachespelvic.physio

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