Pelvic floor myalgia is a term used to describe pelvic pain that emanates from the muscles and nerves of the pelvic floor.  The term typically means an inability to relax the pelvic floor musculature.  This can cause “vaginismus,” pain with intercourse and even dysfunction of bladder and bowel.  

There is also some overlap with pudendal neuralgia, in that when the muscles surrounding the nerves are hyper-constricted, they may create neuralgia.  This may be one cause of pudendal and other nerve pain.

 

As physicians, we often refer anyone with this type of condition to pelvic floor physical therapy. However, i it is important for those of us who treat pelvic pain to be able to very specifically evaluate, diagnose and sometimes treat. This includes pudendal nerve blocks that could be done in the office. It includes vaginal wall trigger point injections and use of vaginal floor injections of botox.  It also includes the very important role of a good pelvic floor physical therapist.  At NW Endometriosis, Drs. Fogelson and Mohling specialize in evaluating pelvic floor pain and dysfunction and, more importantly, treating it.  Treatment may involve vaginal wall trigger point injections or the  use of vaginal wall Botox injections.  Very often we collaborate with pelvic floor physical therapists who are essential in helping relieve this type of pain.  

 

Sometimes, pelvic floor pain is related to an obstetric injury.  In this case, a careful exam helps determine whether a surgical approach will be needed.  Similarly, nerve entrapment can cause pelvic pain and a “neuropelveology” surgical approach may be necessary.  

 

Dr. Mohling has over 30 years of experience working with myofascial pain and trigger points and is able to apply this experience to dysfunction of the pelvic floor.  Dr. Fogelson is one of only a few US surgeons trained in Neuropelveology and is able to apply these techniques when indicated.