Irritation of the pudendal nerve, the nerve that supplies the sensation and muscle control of the pelvic floor and perineum. Symptoms can range from discomfort when wearing tighter clothing to pain with sitting to bowel/bladder dysfunction.
Refers to the dysfunctional activation of the muscles surrounding the anus.
Interstitial Cystitis (IC)/Painful Bladder Syndrome
Can also be referred to as Painful Bladder Syndrome, is a condition noted by inflammation of the lining of the bladder, where one can experience increased urinary urgency, pain before/during/after urination, increased abdominal pain or pressure. Symptoms can range from mild to severe.
Defined as coccyx or tailbone pain that can occur with sitting, transitions from sit to stand, pain with bowel movements or pain with intercourse. Coccydynia can be caused by a malalignment of the coccyx (tailbone) or muscle dysfunction and/or connective tissue surrounding the coccyx.
Defined as pain with vaginal penetration; can be with tampon use, gynecologic exam or sexual intercourse.
Refers to the dysfunctional response of the pelvic floor muscles in response to attempts at releasing. This can significantly affect the ability to have proper bowel movements, cause pain, or lead to further complications.
Levator Ani Syndrome
Typically refers to pain that is experienced due to dysfunction of the levator ani muscles of the pelvic floor; is often used synonymously with the term Pelvic Floor Dysfunction. Symptoms of levator ani syndrome can include pain, bowel or bladder dysfunction or sexual dysfunction.
Persistent Genital Arousal Disorder (PGAD)
Although it is most commonly noted in women, PGAD is a condition that refers to spontaneous, persistent, and uncontrollable genital arousal, with or without orgasm or genital engorgement, unrelated to any feelings of sexual desire.
Irritable Bowel Syndrome (IBS)
A common disorder of the gastrointestinal system where signs and symptoms include abdominal pain, bloating, gas and changes in bowel pattern as increased frequency, constipation or diarrhea. IBS may result from, or may result in, tightened, weakened or incoordination of the pelvic and abdominal musculature.
Defined as the accidental loss of urine. This can be due to muscle spasm or muscle weakness. There are 3 main types of urinary incontinence:
- Urge Incontinence
Urine loss due to a strong urge/desire. Can often occur en route to the restroom or with other triggers such as running water.
- Stress Incontinence
Urine loss due to an increase in intra-abdominal pressure that is greater than environmental pressures. These “stressors” that cause an increase in intra-abdominal pressure can be coughing, sneezing, laughing, lifting or exercise.
- Mixed Incontinence
Urine loss due to a combination of urge and stress incontinence.
Defined as the unexpected leakage of stool from the rectum, is most commonly due to weakness of the pelvic floor and can be successfully treated through conservative physical therapy.
Defined as infrequent bowel movements, difficulty of passage of stool, or incomplete bowel movements. Constipation can sometimes be caused by tight, weak or uncoordinated abdominal and pelvic floor musculature. Constipation, as a result of muscle dysfunction can be conservatively and successfully treated through physical therapy.
Noted when the veins of the pelvis are susceptible to chronic dilation which can result in the inability of the blood in the veins to return to the heart as efficiently. Signs and symptoms of pelvic congestion include pelvic pain, dyspareunia, bowel or bladder dysfunction, leg pain, back pain, possible infertility and, in men, erectile dysfunction.
Inflammatory condition that causes pruritic skin lesions; scarring and adhesions from these lesions can lead to narrowing of the vaginal canal.
Uncommon condition that causes chronic patchy white skin lesions that can often be associated with itching, burning and painful intercourse.
Involuntary spasms of the muscles of the pelvic floor. This can lead to dyspareunia (see above).
Pelvic Organ Prolapse
Weak pelvic floor, chronic straining for bowel movements or poor general core activation strategies with activity such as lifting or coughing can result in the “falling” of one or multiple pelvic organs, including the uterus, bladder or rectum, resulting in symptoms of bowel or bladder dysfunction, sexual dysfunction, or pelvic pain/heaviness. Prolapse can be prevented with proper activation of muscle, good posture/positioning in and out of activity and weight control. If prolapse has already occurred, then physical therapy can help address causative factors, assist in building strength and decrease symptoms. Surgical intervention is sometimes suggested by the physician in more involved cases; physical therapy is still extremely beneficial before surgery in order to be more aware of proper muscle control and healthy bowel and bladder habits.
A medical condition where uterine tissue is found outside the uterus in the abdominal and/or pelvic cavity causing adhesions of the tissues in the area, leading to pain and myofascial dysfunction. It is believed that poor balance of estrogen can exacerbate endometriosis.
Defined as thinning and inflammation of vaginal tissues; symptoms can include abnormal sensations through the vaginal area including itching or burning. This commonly will lead to poor extensibility of the vaginal tissues, causing dyspareunia, or pain with intercourse.
Low back and / or hip pain caused by excess tension or laxity in the iliopsoas muscle (muscle which bends the hip).
An episiotomy is the surgical incision of the lower aspect of the vaginal opening and perineum, performed for various reasons, during delivery. From the natural process of healing, scar tissue can develop. Often times this scar tissue becomes restrictive, leading to pain with touch, sitting or attempts at tampon use or intercourse.
Noted as pain with touch of the vestibule (area surrounding the vaginal opening) or the vaginal opening. Erythema (redness), itching or burning in the area can also be noted.
Defined as pain in the area surrounding the vaginal opening (vulva). Characterized by burning, itching, rawness and dyspareunia.
Defined as a medical condition that causes chronic widespread pain and tenderness to touch and is thought to be the result of overactive nerves. In addition to pain, those suffering from fibromyalgia can also experience fatigue, cognitive and memory problems, IBS, morning stiffness, painful menstruation, numbness or tingling in the extremities or sensory sensitivity.