Can a hypertonic pelvic floor be cured?

The simple answer is yes, but the prognosis depends on the underlying causes of your pain. With our multimodal treatment approach, patients can experience increased pelvic function and decreased pain.

How can I tell if my pelvic floor is tight or weak?

You may experience symptoms such as pain and discomfort within your pelvic floor or may struggle with urinary incontinence or constipation. Our pelvic pain specialists can officially diagnose a tight or weak pelvic floor by doing an internal exam of the pelvic floor nerves and muscles.

What do pelvic floor spasms feel like?

Pelvic floor spasms may feel like a cramp or charley horse in the muscle, which may last a few seconds to a couple of minutes.

When should I seek treatment for my hypertonic pelvic floor symptoms?

We recommend scheduling an appointment with one of our pelvic pain specialists if you have been experiencing symptoms for 6 months or longer.

Do You Suffer From a Hypertonic Pelvic Floor?

Pelvic Floor Muscle Hypertonia

With this condition, pelvic floor muscles are contracted, tense, and weak. Blood flow is restricted, which can cause an acidic environment in the area and this, in turn, can create an inflammatory cascade. PRM’s treatment protocol reverses this cascade, relieving pain and restoring function.

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Quick Answer

Pelvic floor muscle hypertonia, also known as a hypertonic pelvic floor, occurs when the pelvic floor muscles remain excessively tight, contracted, or in spasm and have difficulty relaxing and lengthening. Common symptoms include chronic pelvic pain, painful intercourse, constipation, pain during bowel movements, rectal pain or burning, urinary urgency and frequency, burning with urination, and pain when sitting. Potential contributing factors include recurrent infections, pelvic injury, physical or sexual trauma, stress, anxiety, prolonged sitting, cycling, and habitually holding urine or stool. Pelvic Rehabilitation Medicine evaluates the pelvic nerves, muscles, medical history, and symptoms to identify contributing factors. The PRM Protocol™, an office-based, ultrasound-guided treatment approach, targets spastic pelvic floor muscles, pelvic nerve irritation, and inflammation that may contribute to chronic pelvic pain. A specialist evaluation can help determine an individualized treatment plan.

Understanding Your Hypertonic Pelvic Floor

What is Pelvic Floor Muscle Hypertonia?

Hypertonic pelvic floor is a condition where the muscles in your pelvis are in a spasm. Pelvic Hypertonia in the pelvic floor is defined as tight muscle tone. Hypertonic pelvic floor muscles are short, spastic, and weak. Blood flow is restricted and oxygenation is reduced when muscles are in a hypertonic state. In fact, a 10% increase in pelvic floor muscle contraction can cause up to a 50% decrease in blood flow and oxygen supply. This local restriction in blood flow can create an acidic environment which stimulates an inflammatory cascade.

Symptoms of Pelvic Floor Muscle Hypertonia

The negative cycle that causes the inflammation within the pelvic floor results in a variety of symptoms. The region’s muscles become tender and the nerves become irritated and begin to fire inappropriately, causing chronic pelvic pain. Patients with pelvic floor hypertonia may experience:

Bladder Pain

Chronic Constipation

Coccydynia Pain

Lower Abdominal & Groin Pain

Pain During Intercourse

Pain with Sitting

Pain with Periods

Postpartum Pelvic Pain

Postpartum Sexual Dysfunction

Rectal Pain

SI Joint Pain

Testicular Pain

Urinating Urgency and Frequency

Vaginal Pain

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It’s Not in Your Head

What Causes Pelvic Floor Muscle Hypertonia?

There are many causes for hypertonic pelvic pain, but the main point is that the muscles are becoming contracted, tense, and weak which can be a result of different pelvic floor dysfunctions and other conditions.

Irritable bowel syndrome

Endometriosis

Adenomyosis

Vulvodynia

Fibroids

Pregnancy

Bladder Pain Syndrome/IC

Chronic Prostatitis

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Hypertonic Pelvic Floor

Risk Factors

While there are certain pelvic floor conditions that can cause muscles to become hypertonic, there are other factors that can increase the likelihood of experiencing symptoms.

Recurrent Infections (UTIs, yeast, etc)
Sexual or physical abuse
Injury
Stress, depression, and anxiety
Habitually holding stool or urine
Prolonged Sitting
Biking

Do You Have A Hypertonic Pelvic Floor?

Pelvic Floor Muscle Hypertonia Diagnosis

Diagnosing a hypertonic pelvic floor and the issues that are causing it requires an in-depth examination of both the nerves and muscles within the pelvis, learning of your medical history, and getting a full picture of your symptoms and lifestyle.

Here’s what you can expect when you are a patient at Pelvic Rehabilitation Medicine:

Step One – First, our providers will ask questions about your medical history and listen to your symptoms to get a full picture of what is going on with you.
Step Two – Next, an external exam of your hips, abdomen, and posterior sacrum.
Step Three – Next, your pelvic nerves are evaluated externally with a soft cotton tip.
Step Four – Next, with your consent, gel is placed on a gloved finger and an internal exam is performed to allow us to evaluate the nerves and muscles within the pelvis. There is no speculum required as we are evaluating the pelvic floor muscles and nerves not the organs.
Step Five – Sometimes patients will need Imaging to help us understand if there is an associated cause of the pelvic nerve and muscle pain and dysfunction found on exam.
Step Six – Oftentimes, treatment can be started the same day as there is no down time. Our patients have been suffering with pelvic pain symptoms for 6+ months. We like to get them on the road to feeling better as soon as we can as the longer the symptoms are present the harder it is for us to resolve them.

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PRM Protocol™

Behavioral Therapy Techniques

Nutrition Health Coaching

Men’s Health Services

Women’s Health

Treatment Options for Pelvic Floor Muscle Hypertonia

Once a proper diagnosis has been given, we offer a proprietary office-based procedure to treat the symptoms of a hypertonic pelvic floor. This treatment consists of a series of pelvic nerve and muscle treatments to directly target the spastic pelvic floor muscles, inflammation in the pelvis, and nerve pain. Depending on the condition causing your hypertonic muscles, other modalities may be needed in addition to our treatment.

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Frequently Asked Questions

What are the common symptoms of pelvic floor muscle hypertonia?

Pelvic floor muscle hypertonia occurs when the pelvic floor muscles remain overly tight, contracted, or in spasm and have difficulty relaxing. Symptoms may include chronic pelvic pain, painful intercourse, constipation, pain during bowel movements, rectal pain or burning, urinary urgency and frequency, burning with urination, and discomfort when sitting. Symptoms can affect people of any sex and may interfere with daily activities.

What causes pelvic floor muscle hypertonia?

Pelvic floor muscle hypertonia can be associated with recurrent urinary tract or yeast infections, pelvic injury, physical or sexual trauma, stress, anxiety, prolonged sitting, cycling, and habitually holding urine or stool. Other pelvic, gastrointestinal, musculoskeletal, or urological conditions may also contribute to persistent muscle tension. A specialist evaluation can help identify potential contributing factors.

How is pelvic floor muscle hypertonia treated at Pelvic Rehabilitation Medicine?

Pelvic Rehabilitation Medicine evaluates the pelvic nerves and muscles, medical history, and symptoms to identify factors contributing to pelvic floor dysfunction. The PRM Protocol™, an office-based, ultrasound-guided treatment approach, targets spastic pelvic floor muscles, pelvic nerve irritation, and inflammation that may contribute to chronic pelvic pain. Treatment recommendations are individualized according to each patient’s symptoms and examination findings.