Deep pelvic pain, pain in the area of the coccyx and pelvic floor, pain during sexual intercourse

Deep pelvic pain, pain in the area of the coccyx and pelvic floor, pain during sexual intercourse.

Who is affected?
Generally speaking, pain in the pelvic and pelvic floor can affect both men and women, children are no exception.

When do we often experience pelvic floor pain?
Soreness in the pelvic and pelvic floor area is the result of overloading with unbalanced involvement of muscles in the area of the abdominal wall, back and hip joints. Pain often occurs even when we are exposed to excessive stress, whether at work, at school (especially in children of pubertal age) or in family life.

Pain as a result of injury?
Yes, many of us have already experienced the unpleasant fact of falling on our butts and the subsequent inability to sit down or lie down comfortably for several days or weeks.

When is pain needed to be addressed with specific physiotherapy?
In the above mentioned cases, these are usually functional disorders in the form of increased muscle tension, which usually go away on their own. Sometimes you need to relax your muscles with methods to reduce local tension, either by yourself or with your physiotherapist.

But what if the pain does not go away? What if it prevents us from doing normal activities such as prolonged sitting, sports, sexual intercourse, etc.?

Possible causes of prolonged pain in the pelvic and pelvic floor area:

Scar. Scars after operations in the area of the small pelvis, after an incision or birth injury, or after an injury in the pelvic floor area, can be a source of rather unpleasant pulling to burning and sharp pains. They often annoy during sexual intercourse, but they can also be naughty when defecating. Typical for them is a certain dependence on the position, when changing the position of the pelvis, the pains subside slightly.

Chronic inflammation. Acute gynecological inflammation, inflammation of the prostate or bladder is usually well recognized by everyone. Occasionally, however, the inflammation goes into a chronic phase or “mere dysmicrobia” appears, i.e. a disorder of the natural environment with similar symptoms (burning, itching, discharge) without significant laboratory findings. Rarely, common infections also involve less detectable and otherwise treatable inflammation, such as chlamydia.Such inflammatory changes are a frequent source of adhesions in the pelvic and abdominal cavities at the microscopic level and can lead to nonspecific pain in the lower abdomen, pain during intercourse, with a larger filling of the bladder or intestine.

Endometriosis. This is a condition in which uterine cells travel outside the uterus and settle in the pelvic and abdominal cavity (for example, in the area of the ovaries, fallopian tubes, on the intestines). As part of the normal menstrual cycle, the lining multiplies and can slightly press on the organs. In the period of menstruation, this lining is loosened and there is a very small, but repeated bleeding directly into the abdominal cavity. All this leads to pain in the lower abdomen, the formation of adhesions and often also to bleeding outside the normal menstrual cycle.

Nerve irritation. From the spine towards the pelvis and lower limbs, a large number of nerves protrude. If the nerve is oppressed in its course (for example, by a bulging disc or locally at the point of passage through individual muscles and tendons), it can be irritated and develop burning pains, even in the pelvis, coccyx and genital area.

Symphyseolysis. This is a unique spacing of the bones of the pubic clasp. It appears most often in pregnancy and is characterized by pronounced soreness in the area of the pubic buckle, going even to the inner sides of the thighs.

Dealing with pain in the pelvic and pelvic floor area from the point of view of a physiotherapist:

First of all, it should be mentioned that all of the above conditions should first be examined by a specialist doctor who will appoint proper treatment!!!

In the case of simple high tension in the pelvic floor area, the therapist relaxes the muscles, most often using postisometric relaxation or pressure massage, using so-called external techniques. If the muscles are not sufficiently relaxed, it is possible to proceed to direct, i.e. internal treatment through the vagina or rectum.

In the case of scars or adhesions, a gentle stretching of the adhesions and relaxation of the organs (their stretching) is added to the relaxation of the muscle. The physiotherapist is not able to disrupt the adhesion, but he is able to stretch it and improve the sliding of individual tissues relative to each other and thus relieve the patient. This therapy needs to be repeated regularly, just as we need to stretch regularly so as not to completely stiffen. For this reason, the patient learns to perform the individual techniques himself.If the source of adhesions is chronic vaginal inflammation, it is recommended to include enzyme therapy, rinse salts or cleansing vaginal globules and local use of probiotics.

Irritation of nerves in the spine can in most cases be influenced by conservative, i.e. non-surgical procedures, which also include physiotherapy. Pinching lower in the pelvis can also be partially solved by relaxing the muscles and soft tissues through which the nerve passes. In difficult cases, therapy is supplemented with a targeted injection of a given nerve at a specialized medical workplace.

All manual therapy is supplemented with correction of posture and movement habits in standing, sitting, during sports. As part of complex therapy, we try to adjust the overall muscle imbalance so that the load on the musculoskeletal system is even.

And what if physiotherapy and movement therapy do not help enough?

Last but not least, the pelvic and pelvic floor area is influenced by emotions. If we are afraid or feel uncomfortable, we often contract the pelvic floor muscles and “hide the tailbone”, just as we can see, for example, in dogs.

We often encounter the fact that all our efforts to allow an area are without a significant effect, because the individual solves some other problems, whether work or family. In this case, it is advisable to combine movement therapy with targeted relaxation or psychotherapy.

Mgr. Michaela Havlíčková

Our physiotherapists specialize in pelvic area, pelvic pain, coronary abdomen, menstrual problems, difficulty getting pregnant, incontinence and more. Our physiotherapists will be happy to help you as well. Contact us via the form below and we will contact you immediately.


We are engaged in the diagnosis and therapy of functional disorders of the pelvic floor, as well as deep pelvic pain

Physiotherapy of painful conditions after gynecological and urological operations – BeBalanced




Potřebujete pomoci s tímto problémem?

Objednejte se k nám!
Kontaktujte nás telefonicky
+420 607 225 006