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Diagnosing pelvic floor pain in women

If you suffer from pelvic floor pain, getting an accurate diagnosis for the location and the cause of the pain is a laborious and often elusive experience for many women. Pelvic floor pain occurs when muscles that surround the vagina knot. When the knots don’t release, the pain can become unremitting. The pain can reach a 10 out of 10, with 10 being the worst pain imaginable.

Your physician, physiotherapist, or chiropractor may have told you that you have chronic pain if your pain has lasted for six months or longer. Some women are given pain medication to help manage the pain. Some receive a misdiagnosis and are treated for the wrong issue.

You may have been told that the pain is psychological or psychosomatic and been referred to a psychologist. You may be left feeling a little bit crazy because the pain sure doesn’t feel like it’s in your head.

I have changed the name of the woman and several details in the following story to protect confidentiality. 

One woman, who I will call Michelle, with was told by her male physiotherapist that the pain she was experiencing was referred pain from her discs. She challenged this diagnosis repeatedly but was disregarded.

Michelle’s physiotherapist told her which discs the pain was coming from and treated her for four months for the condition. He told her that she would have pain for the rest of her life because this was a degenerative condition she wouldn’t recover from.

Michelle was sent by a physician for an MRI, and a subsequent epidural to relieve her disc pain. Both her physician and her physiotherapist were baffled when the epidural didn’t relieve her pain because it should have – except that the diagnosis was wrong.

Michelle was fortunate because she had heard about pelvic floor physiotherapists and wondered whether she might get help from a physiotherapist with specialized training in this area. The specialty has only been around for about a decade, so if you’ve heard of it, you’re ahead of the curve.

Michelle was able to book an appointment with a pelvic floor physiotherapist. The physiotherapist was able to diagnosis the problem accurately within 20 minutes of her entering the exam room.

Michelle received sufficient relief to be able to begin to function normally with a couple of months. She had been incapacitated, able only to work and to supervise as others cleaned her house and bought her groceries.

It took several more months before the problem was completely dealt with, but Michelle has recovered and is able to do anything physically that she wants to. If she had listened to her original professionals, she believes she would still be in chronic pain.

Proper evaluation by a pelvic floor physiotherapist or an informed physician are the two routes I am aware of to get an accurate diagnosis of pelvic floor pain. If you believe you may have pelvic floor pain, google the words “pelvic floor physiotherapist” and book an appointment for an assessment.

A word of caution. If you have pelvic floor pain, working with a pelvic floor physiotherapist may prove challenging psychologically because the physiotherapist will have to work with you intravaginally. (These physiotherapists are all women.)

If you find it difficult to allow the physiotherapist to work with you, don’t give up and live with the pain. Instead, you can enlist the help of a compassionate psychologist to  work alongside you.

The best number I know is that up to 98% of women with pelvic floor pain have a history of sexual abuse. (A significant percentage of these women may be unaware that they have a sexual abuse history.) Working with a psychologist that is well-versed in treating sexual abuse may be exactly what you need to help you clear your way to getting help.

Dr. Patricia Turner, Registered Psychologist, Calgary, AB

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