Healthy Beginnings

Addressing the pelvic pain puzzle

Dr. Karla Moore recommends proper breathing techniques, among other tips, to assist with pelvic pain.

Pelvic pain is a very common occurrence affecting 20 percent of women at some point in their life. Further, the diagnosis of prostatitis is the third most common diagnosis in men under the age of 50, and as many as 90 percent of those men actual suffer from pelvic pain.

The pelvic floor is the sling of 14 muscles located between the pubic bone and tailbone that are responsible for controlling urine, controlling feces and gas, and supporting internal organs, postural support of the spine and pelvis and sexual function.

Pelvic pain can be caused by the muscles of the pelvic floor being overactive or tight; a connective tissue restriction; or nerve inflammation. These symptoms lead to pain, weakness and/or dysfunction of the processes in the pelvic region — urinary, bowel and sex.

Some primary reasons for the onset of pelvic floor problems are pregnancy and childbirth; repetitive motion or stress; sitting, driving, cycling and horseback riding; falls onto the tailbone; motor vehicle accidents; surgeries; poor posture; physical or sexual trauma; and straining with constipation or other conditions of the urinary, gastrointestinal or reproductive systems, among others.

As with many persistent pain or musculoskeletal conditions, it is a combination of several factors, and the pain may occur “out of the blue” because of years of a certain activity or stress on the system(s).

Some of the common symptoms of pelvic pain:

In both women and men: perineal or anal pain; pain with sitting and/or exercise; tailbone pain; and pain with urination, urinary urgency, frequency, hesitancy and burning, and/or constipation.

In men: penile, scrotal or post-ejaculatory pain; and erectile dysfunction.

In women: vulvar, vaginal or clitoral pain; labial, vulvar or genital itching; painful menstruation; abdominal or groin pain; sacroiliac joint pain; and/or pain with/after sex or sexual intercourse. 

Treatment strategies:

A team approach will result in an accurate diagnosis and a strategy for the combination of multisystem impairments, not based solely on the diagnosis. Each area of concern should be addressed individually and collectively for a mind-body and whole-life approach to care.

This may involve providers from various specialties, such as physical therapists, gynecologists, urologists and/or oncologists, among others.

For some, implementing a specific exercise program will be the solution — for others, the evaluation and treatment may be much more involved and include several specialists. A physical therapy plan of care may include very specific exercises in addition to hands on/manual therapy combined with other modalities.

It is essential to your overall health for you to receive the care you deserve to resolve your pelvic pain.

Here are some tips to get you started:

  1. Communicate your concerns with your provider. There may be specific tests you will need to rule out or treat certain conditions and necessitate the referral to a specialist.
  2. Seek the care of a physical therapist, preferably one who specializes in pelvic health for providing solutions with an individualized plan of care.
  3. Begin with the least invasive treatment and seek guidance for natural remedies. Unfortunately, pelvic pain is often misdiagnosed as something else, which can lead to the unnecessary use of drugs or surgery.
  4. Breathe! Deep breathing is an excellent place to start while you are working on putting the pieces together.
  5. For a tight pelvic floor, stretching is a great place to start, and the Happy Baby Yoga Pose or deep squat are good places to begin for women and men.

    Dr. Karla Moore is owner of NeuroFit Wellness & Physical Therapy in Reno. Contact her at or 775-863-8766. Visit to learn more.