Pelvic Pain

When we talk about pelvic pain, we’re referring to pain that occurs anywhere between the belly button and the legs. Pelvic pain can be caused by digestive, urinary or reproductive issues, but it can also be caused by damage to the ligaments and fascia of the pelvic floor, buttocks, abdomen, and thighs. Pelvic pain can be a symptom of a life-threatening illness, but it can also be something as simple as a symptom of ovulation during your menstrual cycle.

Though most discussion of pelvic pain revolves around women, pelvic pain affects men as well, and sometimes children and adolescents. Pelvic pain may be embarrassing to talk about, but the problem can be devastating if left unchecked.

Common Causes of Pelvic Pain in Women

Women are much more likely to deal with pelvic pain than men, as there are many causes associated specifically with the female reproductive system:

  • Adenomyosis: A condition where the lining of the uterine wall grows into the uterus’ muscular wall. The lining tissue still acts as lining tissue – bleeding and shedding monthly. This can cause severe, chronic pelvic pain.
  • Endometriosis: One of the many symptoms of endometriosis is debilitating, recurring pelvic pain that results from the overgrowth of scar tissue that is characteristic of endometriosis.
  • Issues with the ovaries: Ovarian cysts, fibroids, scar tissue, ovarian cancer, etc.
  • Pregnancy-related conditions: Anything that damages the reproductive system during pregnancy can cause pelvic pain, including miscarriages, fetal death in-vitro, and ectopic pregnancies.
  • Vulvodynia: Pain at the entrance to the vagina that lasts more than 3 months and has no identifiable cause like STDs, infection or injury to the vulval tissue.

Common Causes of Pelvic Pain in both Sexes

There are many types and origins of pelvic pain that can affect anyone. Some include:

  • Dyspareunia: Commonly known as painful intercourse, this type of pelvic pain is commonly caused by structural problems, damage to genital tissue, muscles spasms, etc.
  • Groin pain: Groin pain is most often caused by injury to the muscles or connective tissues around the groin, and is most common in athletes.
  • Hip pain: Pain in the hips is usually caused by inflamed tendons, wearing of the connective tissues around the hip, or arthritis. However, hip pain can also be referred pain from another part of the body, like in sciatica, for example.
  • Interstitial cystitis: Chronic pelvic pain caused by damage to the bladder’s walls and tissues. Interstitial cystitis can cause hardening and scarring of bladder tissue long-term.
  • Piriformis syndrome: The piriformis muscle is a deep-set muscle in the buttocks. Chronic pain in the buttocks can be caused by the piriformis muscle spasming and putting pressure on the sciatic nerve, but it is more often caused by injury or overuse.
  • Proctalgia: This type of sharp, stabbing pelvic pain happens when your pelvic floor muscles or the muscles of the sphincter and rectum spasm.
  • Prostatitis: Pelvic pain and painful urination caused by inflammation or infection of the prostate and/or its surrounding tissues.
  • Pudendal neuralgia: Pelvic pain caused by damage or compression of the pudendal nerve. This type of pelvic pain is also called Alcock’s syndrome or Pudendal canal. It is rare and usually a misdiagnosis of pain that is instead due to fascia injury.
  • Rectal pain: Rectal pain can have a myriad of causes, from hemorrhoids to bowel disease, infections, or injury to rectal muscles and/or tissues.

Every type of pelvic pain, especially the chronic kinds, are most often generated by muscle and fascia damage, and do not necessarily come from pinched nerves or infection. So before you try any invasive procedures or pain medication regimens, let’s learn a bit more about where pelvic pain comes from and how holistic, regenerative medicine can often remedy the situation.

Identifying the Source of Pelvic Pain

Injury to any muscle in the pelvic floor can generate chronic pain.

Most of the pain in the body comes from muscle and fascia that has been injured. Pelvic pain is no different. However, most doctors and medical professionals, on the other hand, have been taught to think of pain as coming from pinched nerves, spinal problems, and diseased parts that can be taken out with surgery.

This is partly why so many types of pain treatments do not help or the help does not last. The real injury has not been found, and none of the treatments really make the pain go away. The most helpful treatment for pelvic pain may be massage therapy, especially in cases of misdiagnosed pudendal nerve pain. If this is the case, it will help you confirm the pain to be coming from injured muscle and fascia.

We take a different approach to pelvic pain, particularly when it comes to piriformis syndrome. Dr. Blatman prefers to approach the problem of pelvic pain holistically without the need for invasive surgeries or potentially addictive painkillers. This may involve novel therapies such as stem cell therapies or PRP injections — or it could be as simple as therapeutic massage, exercise, and stretching.

What Causes Pelvic Pain from Pudendal Neuralgia?

Pudendal neuralgia — long term pelvic pain — is caused by damage or irritation of the pudendal nerve, a primary nerve in the pelvis that provides sensation to the buttocks and genitals. It can often be experienced as groin or rectal pain.

There are no symptoms that distinguish what is considered to be pudendal neuralgia and pelvic myofascial pain. Burning, crushing, shooting or prickling sensations in the area between your buttocks and genitals are more often due to fascia injury than to nerve injury, a fact that is little recognized in this world of medicine and surgery before touch.

There is no symptom that specifically and definitively indicates that pelvic pain comes from the pudendal nerve. In fact, this pain that is generally attributed to the pudendal nerve is rarely actually from the nerve!

Almost all the time, the pelvic pain is coming from old injuries to the fascia of your inner thighs, buttocks, abdomen, and pelvis. How can you tell? Check by touching the muscles and bones of your pelvis, thighs, groin, buttocks and abdomen. If any of these areas are tender, you may have discovered a clue to the injuries and sources of your pain.

By the Blatman Method for diagnosing, finding, and treating pain, always remember… the only thing you can really believe is what you can touch and feel. If the muscles in your inner thighs, buttocks, or pelvis are tender, the pelvic pain is not coming from your pudendal nerve, so don’t undergo a surgery to release the nerve – it won’t fix anything and you’ll have severed a major nerve for no reason.

How we Treat the pain called: Pudendal Neuralgia

Tender muscles and ligaments, which may feel hot or knotted up, need careful care to heal. Figuring out how to make the tender areas not tender is all about getting the right help. This is difficult, because much of Western medicine overlooks the connective tissues that hold our bodies together. Most often, chronic pain of all kinds, not just pelvic pain, is caused by a lifetime of micro-injuries to the fascia.

At our integrative health and wellness centers in New York and Cincinnati, we treat pudendal neuralgia related-pain naturally — without the use of drugs or invasive surgeries. To treat pelvic pain, we touch and examine your fascia biology, help you understand how specific areas of tenderness illustrate a lifetime of injuries that contribute to causing your pelvic pain, and then show you what it will take to make pelvic pain go away.

Pain is not what we were taught. Everyone understands a piece… chiropractic, physical therapy, doctors, pelvic floor specialists, and lots of these folks are helpful…but you are reading this because you still hurt. And your pelvic pain often does not originate from your pudendal nerve or even your pelvic floor. That’s why everything helps, and yet nothing actually works.

Natural Treatment for Vulvodynia Pain

With respect to standard conventional medicine, there is no known cause for vulvodynia. And as with many chronic pain syndromes specific to women, it has only recently been officially recognized by doctors. Unfortunately, many doctors miss even diagnosing this ailment, mistaking it as yeast infections, bacterial vaginitis, or even STDs.

Vulvodynia is a condition that affects the vulva — either as a generalized pelvic pain in different areas of the vulva at different times, or as localized pain in one specific area of the vulva. The condition can affect a woman’s ability to enjoy sex and exercise.

We can naturally treat vulvodynia through a number of minimally-invasive and natural remedies, including physical therapy, stem cell injections, and TempSure Vitalia, a process that uses radiofrequency to heat the vulva area to encourage the body’s natural production of collagen, which strengthens the skin.

Where do Muscles and Fascia Refer Pelvic Pain?

Injury to muscles along the inside of the thighs underlies most deep pelvic pain.

Injury to muscle and fascia causes the body to form trigger points–which can be felt as knots in the muscles, in the middle of ropey bands of muscle. When they are “active,” they generate radiating pain, and any pain symptom you can describe.

In these diagrams, the “x’s” represent approximate locations of trigger points, and the red speckles represent the areas of likely referred pain. Because pain originating from trigger points can often be referred, it’s important to try holistic remedies like massage therapy, exercise and diet changes before resorting to invasive procedures or pain medication regimens. You might end up worse off than the start.

What does Myofascial Pelvic Pain Feel Like?

Injury to Pelvic Floor muscles causes pain in the pelvis and rectum.

Myofascial pain can be very confusing and misleading to describe. It can be dull, achy, sharp, knife-like, stabbing, shooting, numbing, burning, radiating….there is no pain symptom you can describe that cannot come from injured muscle and fascia. Since this same kind of pain can occur anywhere in the body, severe pelvic pain can be thought of as a “migraine” in the pelvis. What we need to realize is that most chronic pain is a symptom of myofascial damage.

So, when we say, “You’re suffering from Pudendal Neuralgia,” we don’t mean that the pudendal nerve itself is radiating pain; we mean that the nerve has been irritated or compressed in some way, which is causing it to send out pain signals. What’s actually causing your pelvic pain isn’t the pudendal nerve – it’s the damaged muscles, tendons and fascia that are the actual source of the pain.

What Started my Pelvic Pain?

Pelvic pain may begin after a procedure to your bladder, pelvic organs, or hernia surgery. It can also occur in people who have injuries to their hip, pelvic, and thigh muscles from years of running, biking, and other sports. Pelvic pain is also a common symptom in conditions like endometriosis. And sometimes, the pelvic pain is as simple as digestive issues from toxic foods, such as in diverticulitis, or a symptom of the ovulatory stage in your menstrual cycle.

However, it is important to note that while most pelvic pain originates in damaged or inflamed muscles and connective tissues, severe, acute onset of any pain can be a sign of something more serious, like a bacterial infection, cancers or the onset of autoimmune diseases. This is especially true if your chronic pelvic pain is accompanied by fevers, nausea and vomiting. So, especially when it comes to issues around the genitals and reproductive organs, ruling these causes out with CT scans, ultrasounds, colonoscopies and blood tests is vital to preserving your health.

How can Blatman Health and Wellness Center Help?

Dr. Blatman and the staff of the center understand pelvic pain and promote non-destructive and non-surgical treatment options. A careful physical examination will first reveal the tender and injured muscle and fascia tissue that are driving the pain. Our caring staff will then start to instruct you in how to start working on your body to help it heal from pelvic pain. Dietary changes will also be recommended to give your body what it needs to heal faster as well as to decrease inflammation that kinks your fascia cords and strings together and contributes to your pain.

Fortunately, pelvic pain is treatable without the need for invasive surgeries. We have a number of regenerative therapies available that can provide safe, effective and fast relief, such as massage therapy, vaginal rejuvenation via TempSure Vitalia, stem cell treatments and PRP therapies. Where surgeries and pharmaceuticals merely treat your symptoms, regenerative treatments and lifestyle changes can relieve your chronic pelvic pain permanently, because they help heal the source of the problem.


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