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Urinary problems such as pain, urgency and frequency are common, and these symptoms typically affect both men and women. It is often labeled as dysuria, which is the medical term for painful or difficult urination. Urinary pain or burning is often related to kidney problems or infections, which can potentially lead to pelvic floor issues. Our patients are more often experiencing a feeling of urgency, frequency, inability to go or completely empty the bladder. These “control”, or lack of, symptoms are more closely related to the musculature of the pelvic floor versus localized pain or burning.
Urinary urgency and frequency along with other kinds of pelvic pain and discomfort can have many causes. But they can also be related to a single cause: a condition called nonrelaxing pelvic floor disorder, which is not widely recognized but starting to have further medical research and identification.
Many standard medical treatments for pelvic floor dysfunction focus on treating symptoms in isolation with medications, lifestyle changes and even surgery. But ultrasound guided trigger point injections, an innovative technique offered at Pelvic Rehabilitation Medicine, target the source of pelvic pain and discomfort, not just the symptoms.
The pelvis contains many organs and systems, including the bowels, bladder, and for women, the uterus and vagina. All these organs are supported by the pelvic floor, a kind of sling made up of muscles, ligaments and connective tissues. When working properly, the muscles of the pelvic floor tighten and relax as needed to perform functions such as urination and bowel movements.
A number of conditions can cause urinary issues leading to irritation, inflammation or other problems that interfere with the smooth working of the pelvic organs. Urinary issues like burning or pain upon urination, frequent urination and difficulties emptying the bladder can have causes such as bladder infections or interstitial cystitis.
Problems with bowel movements such as constipation, pain, straining or incomplete elimination can also be caused by conditions including irritable bowel syndrome. Other kinds of pelvic dysfunction include painful intercourse for women and prostatitis for men. In women, too, organs such as the bowel or uterus can prolapse into the vagina. More rarely, bowel or bladder cancer may also cause these kinds of symptoms.
Frequently, though, the source of pelvic pain and discomfort can’t be traced to any of these conditions, especially when symptoms affect a number of locations such as the lower back, bladder, and rectum. In those situations, the problem may lie with dysfunction in the way the muscles and ligaments behave in the pelvic floor itself.
When the muscles of the pelvic floor aren’t working properly, it can cause pain, discomfort and other symptoms in the pelvic organs and nearby locations like the lower back. Relaxation of the pelvic muscles can cause symptoms such as urinary or fecal incontinence. But recent research reveals that, in many cases, the cause of wide-ranging pelvic pain and discomfort is actually caused by excessive tightness in the pelvic muscles, causing knots to form in muscle tissues.
These knots, called trigger points, can form in any muscle tissue, and they can often be easily felt in places like the neck or shoulders. In the pelvis and other areas, these points cause pain and irritation in surrounding nerves and tissues. Standard medical approaches to treating pelvic floor dysfunctions include medication such as muscle relaxants, exercises such as yoga, pelvic floor physical therapy, and even surgery. But these techniques aren’t always effective – and symptoms can return.
Our patients often try and make lifestyle or dietary changes hoping to address the problem. Removing items like alcohol, caffeine or gluten may help alleviate but often is not addressing the underlying muscular issues. Items like alcohol or caffeine can often lead to conditions like interstitial cystitis, which then can lead to pelvic floor dysfunction. So removing them may help address one concern but not the other.
The doctors at Pelvic Rehabilitation Medicine take a different approach to treating nonrelaxing pelvic floor disorder and other dysfunctions, targeting the trigger points themselves with ultrasound guided trigger point injections to relax muscles and relieve pain. Ultrasound is a safe and noninvasive imaging technique that helps doctors target the precise location of a trigger point. Patients typically receive a series of injections to resolve all the affected points in the muscles of the pelvic floor. This treatment approach for men with urologic chronic pelvic pain has shown great promise.
Nonrelaxing pelvic floor dysfunction and other problems related to the pelvic floor can cause pain, discomfort, and embarrassment. At Pelvic Rehabilitation Medicine, our doctors treat the whole person, not just a symptom – and we’ll work with you to find the relief your body has been looking for.