Pelvic pain comes from several causes and come from a few different factors. Hormones are the biggest cause with women. These hormones make changes to the pelvic girdle during the menstruation, pregnancy or menopause. This goes together with having a nagging, pulling or sore pelvic pain. The cause of pelvic pain with men AND women can also be a consequence of a surgery, nerve pain, the wrong use of muscles, overactive pelvic floor muscles, weakened pelvic floor muscles, after a fall or trauma, disease, or an organ condition. Pelvic pain can have a lot of causes, that’s why it’s important to discover the cause of yours. With this knowledge you can make a start with a good recovery because pelvic pain is something that you can recover from as well.
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Before we continue with the causes, I’d like to explain some more about the pelvis first. After that, everything will connect like puzzle pieces.
Information about the pelvis
The pelvis is a bone. Well, actually, it consists out of a large variety of bones. You have the sides where the hip sockets can be found, the tailbone is attached to the backside of the pelvic girdle and the pubic bone is located at the front. The pelvis is a collection of bones, protecting your important abdominal organs, e.g. your bladder, intestines and genitalia.
The pelvis itself is a big piece of bone, but this bone, as mentioned before, doesn’t consist out of one part. To keep it simple we will keep it with two big parts of bone. One part is the biggest piece of bone and includes almost everything about the pelvic girdle. This part is called the ilium or iliac crest. These are the sides of the pelvis where your hip sockets are located. You can actually feel the edges of the ilium when you place your hands in your sides.
You can also feel the second piece of bone. This is the sacrum and it’s located in your lower back. If you can, have a good look at the two little dips in your lower back. Make a triangle, with the singular point pointing downwards, ending just above the natal cleft (your bum crack, to put it very crude). That part is the sacrum, a piece of bone that also holds your tailbone.
To keep the iliac crest and the sacrum together, a lot of crisscrossing muscles and ligaments are needed. There is also some kind of joint between those two bone parts to make movement possible. The pelvic girdle is a set of loose bones that need to be held together, this is being done by pelvic ligaments, pelvic floor muscles and the pelvic muscles. These are placed around the pelvis but also in the pelvis to make sure that everything is being held together properly.
The whole bundle is being held together by the pelvic ligaments. For the rest, your bum, abdomen, lower back, groin, and other pelvic floor muscles provide extra support and strength. A lot goes around and through your pelvic girdle, which also means that you can develop issues from every corner. You can experience issues with your muscles, ligaments, nerves or joints.
Now that we know some more about the pelvis, you also understand that there are lot of factors that can cause your pelvic pain. Let’s put the causes altogether and briefly describe them.
Causes of pelvic pain in women
With women, hormones are often the culprit, but we already knew that. And when do these hormones get released? Indeed, around pregnancy. These hormones cause your pelvic ligaments to loosen, the small baby has to be able to fit through it somehow, right? And when these ligaments become looser, more movement in your pelvic girdle is possible. The broadening of the pelvis can cause pelvic pain and a lot of discomfort. This pelvic pain can be a nagging pain and makes it feel like there’s a lot of tension on your pelvis.
Still, your hormonal changes don’t only happen when you’re pregnant. You can also get pelvic pain and other pelvic issues when you:
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- Are menstruating.
- Are pregnant.
- Are in the menopause.
- Are having a disease or condition that influence your hormones.
- Are having a hormonal treatment.
Causes of pelvic pain in women and men
Not just women can experience pelvic pain, because men possess a pelvis too. The pelvis differs in size with men and women but for the rest it’s pretty much the same. The organs in the pelvis do differ of course, but I don’t think I have to explain how.
Now we know that man can also experience pelvic pain, I’ll sum up some causes. These causes count for women and men. In a moment I will also briefly explain them.
Men and women can be met with the following causes for developing pelvic pain:
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- Hypermobility; joints that are too flexible.
- Wrong usage of your muscles.
- Nerve pain.
- After a trauma, for example a fall.
- After a surgery.
- A bladder condition.
Hypermobility and pelvic pain
Hypermobility could of course sound like a blessing. Nice flexible hips and showing off your dancing moves during a salsa lesson. Well, that isn’t really how it is. If you have ligaments that are too flexible because you are hypermobile, that can also cause instability. Think of a hypermobility syndrome called EDS. This instability can cause more movement in your pelvis. Your muscles will have to put more effort into keeping everything together. This in turn can cause overloaded muscles that become too tense. A too moveable pelvis can also cause nerves to become stuck between the different bones of the pelvis.
Wrong usage of your muscles and pelvic pain
Now that we know that there are a lot of muscles in and around your pelvic girdle, you can maybe also imagine that some things can go wrong there. The pelvic floor muscles, back muscles, abdominal muscles, glutes (the muscles in your behind), and your leg muscles all have their own juncture in or around the pelvis. Pelvic pain can be caused by those muscles. In the case of having pelvic pain because of wrong muscle usage, it can be because of the overloading or weakening of these muscles. This often comes from using your muscles in a wrong manner or you’ve been using your pelvic muscles differently because you’ve already been experiencing pain. When you experience pain, you move differently so that you feel as little pain as possible. That’s logical, but this way you’re using your muscles way differently. Maybe one side will weaken and the other side will be overloaded. That’s why it’s important to find the cause of the pain and not to differentiate your way of moving.
Overloaded muscles can put pressure on surrounding nerves. This causes nerve pain. Overloaded pelvic floor muscles can cause a nagging pelvic pain. Overactive pelvic floor muscles have trouble with relaxing and are tensed up pretty much all of the time. This can give you problems with going to the toilet or even problems during sex. These are activities where relaxation is crucial. Urinating and pooping will also become a hard task to do. Being able to get a good erection will also become a problem because the blood can’t properly flow to the penis anymore. With women, getting something inserted in the vagina is also a problem with an overactive pelvic floor. Vaginismus can be caused by an overactive pelvic floor as well.
And yet, it isn’t only possible to develop strong or overactive pelvic floor muscles. They can also become weakened through aging or inactivity. Weakened pelvic floor muscles can cause incontinence issues, numb sex or not being able to hold an erection. It’s crucial to use the pelvic muscles and the pelvic floor muscles in the right way. Here you can find good pelvic floor awareness exercises for men and women.
Pelvic pain because of nerve compression or nerve pain
Next to the many muscles and ligaments, there are also countless of nerves in the pelvis. It’s a whole infrastructure of nerves that tries to go from your brains to your toes (and everything in between). You often notice nerve pain during a specific movement. A nerve will become irritated which causes it to give issues. A nerve will mainly become irritated when it’s stuck or compressed. A stabbing, radiating pain is how you recognize nerve pain next to pelvic pain.
Nerve pain is one of the most painful pains that you can experience. A compressed nerve in your pelvic girdle will cause you a lot of pain, but it can also influence specific functions of your organs. Get help when you feel pain during specific movements like sitting, ducking, haunching, etcetera. You will feel this pain in your groin, butt, abdomen, back, or legs.
Pelvic pain after a surgery
Your body is temporarily dysregulated after a surgery. Your pelvic floor muscles could be weakened, and when a muscle group is weakened, another muscle group can become overloaded in return. This is to compromise for the weakened muscles.
Pelvic pain in women after a surgery
Women can expect a surgery around the pelvis area when there’s an organ prolapse, or when there are a few forms of cancer, e.g. bladder cancer, cervical cancer, or intestinal cancer. The surgery can cause for the pelvic floor muscles to be heavily dysregulated, which makes a good and solid recovery necessary. The pelvic floor muscles are weakened and urinal or fecal incontinence is right around the corner. I have a few exercises ready for you so you can train your pelvic floor muscles after a surgery.
Pelvic pain in men after a surgery
Men are prone to quickly developing pelvic issues like incontinence issues or erection issues after a surgery. A bladder, intestine, or especially a prostate surgery are known to cause pelvic pain in men. For example, after a surgery for prostate cancer, the chance of developing pelvic pain is very high. The injury already causes pain by itself, but the surrounding muscles and nerves are also affected. Muscles quickly become dysregulated and in turn become weakened. Nerves are quick to become irritated or maybe even damaged. Though, recovery is possible in most cases. Don’t wait too long with taking this on. The sooner you start with your recovery, the sooner and the better you will recover from your pelvic pain and pelvic issues. I have collected a lot of exercises for when this is the case for you. Take a look at my tips and exercises for more information.
Pelvic pain after a fall or a different trauma
An accident is in every corner. A fall from the stairs, bike, or tripping over the curb can happen like that. And when you fall on your pelvis it can cause quite the damage and issues. Think of having a nice ice skating session, if you were to fall on your tailbone it can be very painful. Your ligaments might be strained, you may have got a small fracture or a muscle is bruised/torn. You don’t have to notice these issues straight away, they can still come up overtime. Think of a small fracture that isn’t healed properly, for example. Or a nerve that becomes compressed. These are all ways to encounter pain after a fall or a different trauma.
Pelvic pain and a bladder condition
Do you suspect having a type of chronic bladder condition? Maybe it isn’t a bladder infection but interstitial cystitis (IC). IC is also known as a painful bladder syndrome (PBS). With a common bladder infection you’re having issues with bacteria, which isn’t the case with PBS. Here is how you can recognize PBS:
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- Pain in or around the pubic bone.
- Having to urinate very frequently.
- An irritated bladder. When the bladder fills up you’re experiencing a feeling of discomfort.
- Pain in and around the pelvis.
If you’re continuing too long with these issues, you can also develop chronic pelvic pain. Always go to a professional, for example a urologist. I’m sure they can help you within a short period of time!
What to do with pelvic pain
Pelvic pain can be caused by a lot of experiences. It’s good to know that you can do a lot about it yourself. You can start with pelvic floor muscle exercises, pelvic exercises, or look for a specialist. Exercises make you stronger and more aware. And if that doesn’t help you, you can always go to a pelvic specialist. A pelvic trainer, pelvic physical therapist, pelvic exercise therapist, doctor, urologist, or gynecologist can mean a lot to you. Don’t be embarrassed, because you aren’t the first and the last with pelvic pain.
Recovering from pelvic pain
The most types of pelvic pain will disappear after 3 to 5 months, because pelvic pain is often tied to a certain period, e.g. a pregnancy, recovery from a surgery, or recovery after a fall or different trauma. You can also accelerate your recovery when you’ve become more aware of your pelvic girdle. If you’re having issues with a weakened pelvic floor, then you can strengthen it with pelvic floor exercises. If you’re having issues with an overactive pelvic floor, then you can learn how to relax it with relaxation exercises. Recovery is certainly possible. Take a look at my exercise page for the right type of pelvic floor exercises for you.
The chronic pelvic pain syndrome (CPPS)
There are also cases where you’re experiencing pelvic pain that lasts over 5 months. Pelvic pain can also become chronic. This is what we call the chronic pelvic pain syndrome (CPPS). You have CPPS when your pelvic pain lasts longer than six months. If you would like to read more about CPPS, click here.
And lastly, are you looking for more information?
Hopefully this information was useful to you! We’ve discussed how pelvic pain can be caused, the co-existing conditions with pelvic pain, how you can recover from pelvic pain, and we’ve addressed CPPS. If you’re still looking for some more information, feel free to take another look around on the website. It’s filled with in-depth information, tips a webshop and also exercises. I still have a lot of articles with lots of information about other symptoms and issues. Feel free to click on the blue words to take you straight to the right page.
