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Pelvic floor physical therapy for management of myofascial pelvic pain syndrome in women

Rhonda K Kotarinos, PT, DPT
Section Editor
Linda Brubaker, MD, FACS, FACOG
Deputy Editor
Kristen Eckler, MD, FACOG


Pelvic floor physical therapy is the general term used to describe a variety of treatments utilized by physical therapists for the management of pelvic floor dysfunction. Pelvic floor dysfunction is a global term used to describe conditions such as pelvic organ prolapse, fecal or urinary incontinence, and chronic pelvic pain. Myofascial pain syndrome is a potential etiology of chronic pelvic pain.

For women with pelvic organ prolapse and incontinence issues, the therapist develops a treatment program that addresses the weakness of the pelvic floor and related structures, including but not limited to the abdominal wall and hip girdle musculature [1]. This program may include pelvic floor muscle training, biofeedback, and electrical stimulation. (See "Pelvic organ prolapse in women: An overview of the epidemiology, risk factors, clinical manifestations, and management" and "Treatment of urinary incontinence in women" and "Fecal incontinence in adults: Etiology and evaluation".)

Many experts believe that many, if not most, women with chronic pelvic pain have some degree of myofascial pelvic pain syndrome, a disorder in which pelvic pain is attributed to short, tight, tender pelvic floor muscles, usually with myofascial trigger points. (See "Clinical manifestations and diagnosis of myofascial pelvic pain syndrome in women".)

Management of myofascial pelvic pain syndrome may also utilize pelvic floor muscle training, biofeedback, and electrical stimulation. However, additional forms of pelvic floor physical therapy may be employed secondary to the unique pathophysiology of this syndrome, which involves changes in the length tension relationship of the muscle, as well as changes in neural function. (See "Clinical manifestations and diagnosis of myofascial pelvic pain syndrome in women", section on 'Etiology'.)

This topic provides an overview of the conceptual framework from which physical therapists approach pelvic pain syndromes. It is intended to inform clinicians who refer patients for this intervention. An overview of multimodal treatment approaches to this disorder is presented separately. (See "Treatment of myofascial pelvic pain syndrome in women".)


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Literature review current through: Oct 2015. | This topic last updated: May 21, 2015.
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