The pelvic floor is a group of muscles that connects the pelvis bone to the sacrum, the bottom of the spine. Its primary function is to support the organs of the pelvis area, including the bladder, rectum, uterus in women, and prostate in men. The pelvic floor provides additional support to women’s organs, including the urethra, and vagina. The pelvic floor is essential for the proper function of the organs it supports. The relaxation and contraction of these muscles allows for urination and bowel movements, and for women, sexual intercourse. Pelvic floor muscle dysfunction occurs when the muscles of the pelvic floor do not coordinate correctly to allow for these processes. It is often the case that the muscles are too tense when they should be relaxed, allowing for easy bowel movement, urination, and intercourse for females.
- Frequent and sudden urination
- Sudden starting and stopping of the urine stream
- Painful/Incomplete bowel movements
- Pain during intercourse for women
- Pelvic spasms
- Pain in the pelvic area and lower back
Pelvic floor muscle dysfunction has many possible causes. It can be associated with an impairment of the sacroiliac joint, lower back, coccyx, or hip joints. Pelvic floor muscle dysfunction can be secondary to pathology in the pelvic organs, in which the tissues surrounding the pelvic organs have increased sensitivity or irritation resulting in upregulation of the sensory nerves causing persistent pelvic pain. It is most common in women who have undergone the strain of childbirth, pregnancy, or menopause. It can also be related to trauma to the pelvic area.
DIAGNOSIS OF PELVIC FLOOR MUSCLE DYSFUNCTION
Dr. Shrikhande is able to diagnose pelvic floor muscle dysfunction using multiple types of internal and external physical tests. First, a patient will be questioned about his or her medical history, including information about chronic urinary tract infection, when pain is at its peak, and pregnancies. Dr. Shrikhande may then feel the muscles of the pelvic floor externally, checking for knots, weaknesses, or misalignment of the sacroiliac joints. If further examination is necessary to make a full diagnosis, electrodes will be placed around the pelvic region that will stimulate and measure the muscles’ ability to relax and contract.
TREATMENT FOR PELVIC FLOOR MUSCLE DYSFUNCTION
Dr. Shrikhande may advise multiple types of treatments for pelvic floor muscle dysfunction, all with the aim to strengthen and control the muscles.
- Individually tailored exercises, which may be done at home or with the help of a physical therapist.
- Biofeedback, which is the use of small probes that will use electrical impulses to train the muscles of the pelvic floor with the help of a Physical Therapist.
- Dr. Shrikhande also offers effective trigger point or BOTOX injections, during which a thin needle is inserted into the most painful sites of the pelvic area, called trigger points. This will relax the commonly tight muscles of the pelvic floor. These injections can be part of a physical therapy routine.
- Peripheral Nerve Blocks