Pelvic pain often presents as ongoing aching, pressure, or heaviness in the lower abdomen or pelvic region. In some cases, the pain may radiate to the tailbone, hips, or buttocks, and may also affect the genital area, such as the vagina or perineum.
People with pelvic pain may notice discomfort with prolonged sitting, sexual activity, or daily movements. It is also common for pelvic pain to be accompanied by bladder or bowel symptoms, such as difficulty emptying, urinary frequency, constipation, or straining. While symptoms may be mild or intermittent for some individuals, others experience pain severe enough to interfere with work, exercise, sleep, and overall quality of life.
When pelvic pain becomes persistent, it can also take an emotional toll. Many people report increased stress, anxiety, frustration, or a constant feeling of tension in the body. Over time, this can lead to reduced activity levels and decreased confidence in daily life.
Pelvic pain can affect people of all genders and ages, and symptoms may vary widely from person to person.
Common Causes of Pelvic Pain
Pelvic pain is often multifactorial, meaning there is rarely a single cause. Common contributors include:
Chronic Pelvic Pain Syndrome (CPPS)
Endometriosis-Related Pain
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, commonly within the pelvic cavity. This can lead to inflammation, adhesions, and significant pelvic pain. Even after medical or surgical treatment, pain may persist due to muscular and nervous system involvement.
Musculoskeletal Factors
Overactive or tight pelvic floor muscles, myofascial trigger points, hip or pelvic joint dysfunction, and poor posture can all contribute to recurring pelvic pain. Prolonged sitting, stress, or habitual muscle guarding may increase tension in the pelvic floor and surrounding structures, affecting bladder, bowel, and sexual function.
Nerve and Inflammatory Factors
Nerve irritation or compression, such as pudendal nerve involvement, as well as chronic pelvic inflammation or scar tissue from prior infection or surgery, can result in persistent pain—even without a recent injury.
Other Pelvic Conditions
Conditions such as uterine fibroids, irritable bowel syndrome (IBS), or interstitial cystitis may also contribute to pelvic discomfort, often accompanied by urinary urgency, bowel changes, bloating, or pelvic pressure.
Because pelvic pain often involves multiple systems, such as muscles, nerves, joints, and organs, a comprehensive evaluation is essential to guide effective treatment.
Physical Therapy Treatment for Pelvic Pain
Pelvic health physical therapy plays a key role in treating pelvic pain by addressing underlying movement and muscle dysfunction rather than focusing solely on symptoms.
Treatment may include:
Manual Therapy
Gentle, targeted hands-on techniques are used to reduce muscle tension, release trigger points, and improve tissue mobility in the pelvic floor, hips, lower abdomen, and tailbone region. When appropriate, treatment may also include visceral manipulation, a gentle manual approach that addresses mobility restrictions of the abdominal and pelvic organs and their surrounding connective tissues.
By improving the movement and interaction between muscles, joints, organs, and connective tissues, manual therapy can help decrease pain, improve circulation, reduce protective guarding, and restore overall comfort and function.
Movement Retraining and Coordination
Patients are guided through posture correction, functional movement training, and core coordination exercises. Therapy focuses on improving how the abdominal muscles, hips, and pelvic floor work together during daily activities.
Breathing and Relaxation Strategies
Deep diaphragmatic breathing is used to help retrain the pelvic floor to relax and contract appropriately. This is especially important for individuals whose pain is related to chronic muscle guarding or tension.
Real-time ultrasound imaging may be used as a visual biofeedback tool, allowing patients to see how their pelvic floor and deep core muscles move and respond during breathing and relaxation exercises.
Pelvic Floor Muscle Training
When appropriate, the physical therapist will use specific pelvic floor muscle facilitation techniques to guide training. This may include the use of tactile feedback, verbal cueing, and movement-based strategies to help patients correctly activate, coordinate, and relax the pelvic floor muscles. When indicated, these techniques may be combined with ultrasound-guided biofeedback or other tools to improve muscle awareness and control.
The goal is not simply strength, but the ability to appropriately engage and fully relax the pelvic floor in daily activities.
Our Specialized Approach
Our clinic provides specialized pelvic health physical therapy. Our therapists have advanced training in pelvic floor evaluation and treatment, including advanced coursework through Herman & Wallace Pelvic Rehabilitation and specialized training in rehabilitative ultrasound imaging. This expertise is combined with a strong background in musculoskeletal and neuromuscular rehabilitation, including the treatment of common orthopedic conditions and sports-related injuries. This integrated, whole-body approach allows us to address pelvic pain and dysfunction comprehensively—supporting patients not only in symptom relief, but also in restoring function, movement confidence, and overall quality of life.
Care is highly personalized and delivered in a private, supportive environment. We take the time to listen, educate, and collaborate with each patient to build trust and ensure that treatment feels safe, effective, and appropriate, especially for individuals with long-standing or complex symptoms.
When to Seek Help
Pelvic pain is a real physical experience, even when medical tests do not show a clear cause. In many cases, pain is related to soft tissue and nervous system dysfunction rather than permanent damage. With proper assessment and guided treatment, meaningful improvement is often possible.
You do not have to live with pelvic pain.
We invite you to schedule an appointment to learn how pelvic health physical therapy can help you move, sit, and live more comfortably again.
Ready to Feel Like Yourself Again?
We understand that pelvic health concerns are deeply personal and can sometimes feel overwhelming. Please know that you don’t have to navigate these changes alone.
Our goal is to provide a safe, supportive space where you are truly heard and cared for. Whether you are seeking relief from discomfort or looking to feel more like yourself after major life changes, we are here to partner with you at your own pace.
Whenever you’re ready, we’re here to listen. Contact us today to book your appointment.
We are happy to answer any questions you may have or help you schedule a quiet, one-on-one session.
