Myofascial Pelvic Pain: Causes, Relief & Rehab post thumbnail image

Best Myofascial Pelvic Pain Treatment in Delhi

Myofascial pelvic pain treatment and cure
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What is Myofascial Pelvic Pain ?

Myofascial Pelvic Pain (MPP), also known as Myofascial Pelvic Pain Syndrome (MPPS), is a chronic pain condition that affects the muscles of the pelvic floor and the surrounding connective tissue (fascia). It is characterized by the presence of myofascial trigger points – localized, often painful lumps or nodules within the skeletal muscle or fascia – which can cause both local and referred pain in the pelvic region and beyond.

Causes of Myofascial Pelvic Pain

The exact cause of MPP isn’t always clear, but it often arises from a combination of factors that lead to muscle tension, irritation, and the formation of trigger points. These can include:-

  • Mechanical Factors:
    • Trauma: Direct injury to the pelvic area (e.g., falls, accidents, birthing trauma, prior surgeries).
    • Repetitive Strain: Activities that repeatedly stress the pelvic floor muscles, such as certain exercise regimens (e.g., cycling, spinning), heavy lifting, or prolonged sitting.
    • Poor Posture/Body Mechanics: Chronic poor posture, ergonomic stressors, leg length discrepancy, scoliosis, or pelvic torsion can put undue strain on pelvic muscles.
    • Joint Hypermobility: Excessive flexibility in joints can lead to muscle compensation and strain.
    • Muscular Strains: Increased demand on pelvic floor muscles leading to decreased circulation, localized hypoxia, and ischemia.
  • Emotional and Psychological Factors:
    • Stress and Anxiety: Chronic stress and anxiety can lead to muscle clenching and tension, making individuals more prone to developing trigger points.
    • Depression: Often co-occurs with chronic pain conditions and can contribute to the activation of trigger points.
    • Hyper-responsible personalities: Certain personality traits may increase susceptibility.
  • Associated Medical Conditions: MPP can exist alone or alongside other conditions, which may contribute to its development or exacerbate symptoms:
    • Gynecological disorders: Endometriosis, vulvodynia, dyspareunia (painful intercourse), urogenital atrophy, perineal scarring.
    • Urological conditions: Interstitial cystitis/painful bladder syndrome, frequent or urgent urination.
    • Gastrointestinal conditions: Irritable bowel syndrome (IBS), chronic constipation, pain with bowel movements.
    • Musculoskeletal disorders: Fibromyalgia, hip and sacroiliac joint dysfunction, coccydynia (tailbone pain), lumbar spondylosis, pubic symphysis disorders.
    • Nerve injury: Injured or trapped nerves (e.g., pudendal nerve) from surgery or repetitive activities.
    • Chronic pelvic inflammatory disease.
Symptoms of Myofascial Pelvic Pain

Symptoms of MPP are primarily caused by tender points and MTrPs in the pelvic floor muscles. These trigger points often refer pain to adjacent or even distant sites, and the pain patterns may not follow classic nerve or dermatomal distributions. Common symptoms include:-

  • Pelvic Pain:
    • Can be constant or intermittent, vague and generalized, or sharp and specific.
    • Described as aching, heavy, deep, burning, cramping, stabbing, or stinging.
    • Located in any area of the pelvis and pelvic floor, including the perineum, vagina, urethra, rectum, abdomen, back, hips, and lower legs.
    • Clitoral and rectal pain may be sharp and piercing.
  • Pain with specific activities:
    • During sexual intercourse (dyspareunia).
    • While having a bowel movement or urinating.
    • When sitting or standing for long periods.
  • Urinary Symptoms: Urgent or frequent need to urinate, sensation of incomplete bladder emptying.
  • Bowel Symptoms: Constipation, pain before, during, or after defecation, sensation of incomplete bowel emptying, bloating.
  • Other Symptoms:-
    • Heaviness or dullness in the pelvic area.
    • Sensation of a bulge or something falling out.
    • Sleep problems due to pain.
    • Difficulty finding a comfortable sleep position.

The severity of pain can range from mild to intense, sometimes leading to significant disruption of daily activities, work, and sleep.

Advanced Physiotherapy for Myofascial Pelvic Pain
  • Manual Myofascial Physical Therapy (MPT): This is a hands-on approach by a trained specialist targeting soft tissues like muscles and fascia.
    • Myofascial Trigger Point Release: Applying direct pressure to trigger points until the muscle relaxes. This can be done internally (intravaginal and intrarectal) or externally.
    • Myofascial Release (MFR): Gentle, sustained pressure applied to restricted fascia to encourage elongation and release of tension. This can involve direct or indirect techniques.
    • Pelvic Myofascial Mobilization: Techniques to improve mobility and reduce restrictions in the pelvic fascia.
    • Connective Tissue Manipulation: Techniques like “skin rolling” to release restrictions in the abdominal wall and other connective tissues.
    • Scar Release: Addressing adhesions and restrictions from previous surgeries or injuries.
    • Manual Visceral Therapy: Gentle manual techniques to address restrictions around internal organs that may be contributing to pelvic pain.
  • Therapeutic Exercises and Movement Re-education:
    • Stretching Techniques: Gentle stretching of the pelvic floor muscles and surrounding areas to improve flexibility and reduce tension.
    • Strengthening Exercises: Once tension is reduced, strengthening weak muscles to improve overall pelvic stability and function.
    • Diaphragmatic Breathing: Teaching proper breathing techniques to promote relaxation of the pelvic floor.
    • Posture Correction and Body Mechanics Training: Identifying and correcting poor posture or movement patterns that contribute to muscle strain.
    • Functional Movement Retraining: Helping patients move in ways that minimize stress on the pelvic floor during daily activities, exercise, and work.
    • Dry Needling: Involves inserting thin needles into trigger points to elicit a “twitch response” and release muscle tension.
    • Electrical Stimulation: Low-level electrical currents may be used to reduce pain and muscle spasm.
    • Therapeutic Massage: General massage to promote relaxation and reduce muscle tension.

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