Pelvic Pain Diagnoses for men & women

Pelvic Floor Muscular Dysfunction presents itself in 2 basic ways:

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A hypertonic pelvic floor

Characterized by overactivity and spasm. 

Common signs and symptoms of a hypertonic pelvic floor:

  • Achy pelvic discomfort or pressure
  • Dyspareunia (pain during or after intercourse)
  • Vaginal, perineal or rectal pain (sharp, burning, throbbing, or radiating)
  • Pain in the abdomen, lower back, coccyx, suprapubic area, or hips
  • Urinary hesitancy or retention
  • Painful urination
  • Urinary urgency/frequency
  • Pain with prolonged sitting (coccyx pain or seat bone pain)
  • Inability to use tampons
  • Pain with annual pelvic examination

A hypertonic pelvic floor is also known as pelvic floor tension myalgia or pelvic floor muscle spasm. When a hypertonic pelvic floor is present, patients typically present with various pain syndromes such as Interstitial cystitis, vulvodynia, vulvar vestibulitis ( vestibulodynia), coccydynia, painful intercourse (dyspareunia) and pudendal neuropathy.  These diagnoses are among the many pain syndromes routinely treated in our practice.  While each of these conditions is very different in terms of presentation, the common denominator that exists between them is muscular hypertonicity of the pelvic floor.

A hypotonic pelvic floor

Characterized by laxity and weakness.

Common signs of a hypotonic pelvic floor:

  • Stress urinary incontinence
  • Urge urinary incontinence
  • Mixed urinary incontinence
  • Fecal incontinence
  • Gas incontinence
  • Pelvic organ prolapse - bladder
  • Pelvic organ prolapse - uterine
  • Pelvic organ prolapse - rectal

Treatments for these conditions are very different than those for a hypertonic pelvic floor as weakness and laxity are often hallmark characteristics.  Strengthening of the inner core and the pelvic floor is the foundation of treatment for pelvic floor laxity.  Each patient’s individualized plan of care is established only after a thorough evaluation by one of our pelvic floor PT specialists is completed.



Specific Diagnoses We Treat

Treatment at Sarton Physical Therapy

Pelvic Pain and Sexual Pain Conditions:

Musculoskeletal Dysfunction:

  • SI joint dysfunction
  • Coccyx or tailbone pain
  • Pubic pain
  • Lumbosacral strain
  • Fibromyalgia
  • Osteoporosis
  • Abdominal wall hernia - diastasis recti
  • Piriformis syndrome
  • Low back, hip, pelvic problems that haven’t responded to previous physical therapy

Bowel Dysfunction:

  • Fecal or gas incontinence

  • Constipation

  • Irritable bowel syndrome

Bladder Dysfunction:

  • Urinary incontinence- stress, urge, or overactive bladder
  • Voiding difficulties or urinary retention
  • Urinary urgency and frequency

Post Surgical Dysfunction: