What causes pelvic pain

Pelvic pain is a common occurrence in women, especially women who are or have been pregnant. But it’s not only pregnant women that suffer from this pelvic discomfort. It can also occur in women who haven’t had children and even men. But what causes pelvic pain? Pain felt in the pelvis region is multi-factoral and there are several reasons you may be experiencing discomfort in this area. Lets chat about the who, what, why and when of pelvic pain.

What does pelvic pain feel like:

We usually categorize pain as pelvic pain when it is felt below the belly button and between the hips. Common areas of pain include near the groin, around the low back/ buttocks region, near the pubic bone, and even felt as pain or pressure in our nether regions. Pelvic pain can be felt as a dull ache, pressure, pulling, or sharp sudden pain.

When does pelvic pain occur:

Pelvic pain in women most often occurs during pregnancy. To think we can lug around a bowling ball for 9 months and it not effect our pelvis is wishful thinking. But women can have pain in their pelvis after pregnancy, even several years later. Pelvic pain occurs when there is extra stress, a misalignment, or some type of muscle imbalance in our pelvic girdle often during or after pregnancy. But it can also occur in non pregnancy related ways from everyday activities that put your pelvis in poor alignment. For example, when men sit on their wallet in their back pocket it can throw their pelvis out of alignment. Surprise, men can have pelvic pain too.

Why does pelvic pain occur

Ah, the million dollar question. Why does pelvic pain occur? There are several causes for pelvic pain related to musculoskeletal imbalances or a misalignment of the pelvis. However, there can also be other medical causes for pain felt around the pelvis and if you have pelvic pain that doesn’t go away you should always consult your doctor. But lets chat about the common muscle and alignment reasons.

Pelvic pain explained:

Lets have a quick anatomy lesson. The pelvis is composed of two main bones, which you can think of as the “hip bones”. You have a one on the left and one on the right that are joined by the sacrum in the back and joined by your pubic symphysis in the front. Our pelvis is often referred to as the SI joint, or sacroiliac joint. A typical, healthy, pain free pelvis has symmetrical alignment where the two bones line up nicely and each rotate the appropriate amount as you bend over, flex your hip, or generally move about in life. However, sometimes the pelvis can become misaligned where one bone is rotated too far forward or backwards, or one is up too high. This is going to cause pain and pulling of the tissues, muscles, and ligaments that surround your pelvis.

Pregnancy and Pelvic Pain

Pregnancy is also a big contributor to pelvic pain. During pregnancy the hormone relaxin allows your ligaments and muscles to become more lax to allow room for the baby to grow. And as the baby grows it places extra stress and pressure on your pelvis and pelvic floor muscles. All of this together places your pelvis at increased risk for becoming misaligned.

Another cause of pelvic discomfort in pregnancy is pubic symphysis pain. Your two pelvic bones meet together in the middle and form a joint known as the pubic symphysis. It is located right in front of your bladder. I could write a whole additional blog post about pubic symphysis pain but just know that it can become very unstable, irritated, and contribute to pelvic pain during pregnancy.

Pelvic pain can also be related to problems with the muscles of your pelvic floor. Frequently after having a baby our pelvic floor muscles are too tight or too weak. If you feel you are having problems with your pelvic floor you should consult with your doctor and consider a referral for women’s health physical therapy for a complete assessment.

Pelvic pain vs. hip pain vs. back pain

An important fact to remember is the body is a chain. When one body part (or link) is not working properly another link up or down the chain will be effected. And our pelvis is part of our core which is the base of our body. Consequently, pelvic pain or misalignment can also cause pain in our hips and in our lower backs.

Treatment to help pelvic pain

Exercise:

Musculoskeletal imbalances, aka when the muscles surrounding a body part are not working in a balanced manner, is a common contributor to pelvic pain. Tightness of the hip adductors, tightness or weakness of the pelvic floor, weakness of the pelvic stabilizers, and core weakness are usually some of our first suspects when someone has pelvic pain. This can be rectified with strengthening and pelvic stabilization. Check out some quick and easy pelvic stabilization exercises here and basic core stabilization exercises here. Sometime a special muscle energy technique can be used to help “reset” our pelvis. Stay tuned for my next post this week that is all about exercises to help pelvic pain.

SI Belt:

As previously mentioned our pelvis is also referred to as our SI joint. And a very helpful product to provide external stability to our pelvis is an SI belt. An SI belt is useful when the muscles surrounding the pelvis are not yet strong enough and you are experiencing pelvic or back pain due to joint instability. They offer SI belts for both pregnant and non-pregnant people. I wore an SI belt for several weeks while I was pregnant with my son and it provided stability to allow a muscle strain in my lower back to heal.

Position or Activity Modification:

Sometimes pelvic pain is a result of an activity or position we are putting ourselves in everyday. For example activities that require you to stand on one leg (putting on pants, shoes, climbing into bed, etc) can increase your pelvic pain during pregnancy. Instead, try sitting down to put your pants on and off to reduce the stress place on your pelvis. 

As I previously mentioned, men often sit on their wallets which places their pelvis in a asymmetrical position. This will lead to tightness and pain in either their pelvis or low backs. Take note of where and how you are sitting and ensure that you are sitting with good symmetrical alignment in the car, on the couch, or in your desk chair.

So what’s next?

There are many possible contributors to musculoskeletal related pelvic pain. Pregnancy, muscle imbalances, and improper positioning are leading causes of pain. Later this week I will post some quick easy exercises to help “reset” your pelvis as well as stretches to aid in prevention of asymmetrical pulling. So be sure to come back and check it out.

-Monica