The pelvic floor is a collection of muscles and tissues located at the base of the pelvis to support the bladder, bowel, and reproductive organs, and provide stability for the body. When the pelvic floor muscles spasm or tighten involuntarily, urination, bowel movements, sex, and physical activities can become uncomfortable and often painful.
Here, we’ll discuss what causes pelvic floor muscles to spasm, the symptoms, treatment options, and what you can do at home to relax this crucial part of the body for a better quality of life.
How The Pelvic Floor Works
As the base of the ‘core’ or abdominal muscles, the pelvic floor works in unison with the back muscles and diaphragm to support the spine and body movement. Stretching like a sling or hammock from one side of the pelvis to the other and from the pubic bone at the front to the tailbone at the back, the pelvic floor is an intricate intertwining of muscles and tissues.
Within these intertwining muscles and tissues are specifically placed openings for the anus, urethra, and vagina. When the pelvic floor muscles contract (tighten), the openings for the anus, urethra, and vagina close. When the pelvic floor muscles relax, these openings allow for feces, urine, and wind to be excreted from the body.
For women, intended contractions (or squeezing) of the pelvic floor muscles also help with sexual arousal and pleasure. During pregnancy, the pelvic floor muscles support the womb and growing baby, and when it comes to childbirth these muscles instinctively know to relax.
What Are the Symptoms of Pelvic Floor Muscle Spasms?
Pelvic floor muscle spasms can be constant or come and go. However, most women won’t know when their pelvic muscles are spasming, it is typically the ensuing symptoms that are noticed.
The most obvious symptom of spasming, tight, or hypertonic pelvic floor muscles is pelvic pain. It can feel like mild pain in the lower back, lower abdomen, hips, and sometimes the thighs. For others, the pain can become a constant sharp or dull ache. The pain can intensify during bowel movements, intercourse, or while urinating. It can also feel worse while standing, sitting, or exercising.
Additional symptoms of spasming pelvic floor muscles can include:
- A burning sensation when peeing
- A more frequent urge to pee
- Difficulty starting a stream of pee
- Constipation
- Diarrhea
- Pain during sex (dyspareunia)
- Pain when inserting a tampon or gynaecological instrument
- Inability to orgasm
What Causes Pelvic Floor Muscle Spasms?
Pelvic floor muscle spasms occur when something causes the muscles to involuntarily tighten and not relax as they ordinarily would. This tends to result in a feeling of constant tension, tightness, or pain in the pelvic region for some, while for others, the sense of tightness can come and go.
Situations or conditions that cause this involuntary tightening often include:
Pelvic Injuries or Surgeries
When the pelvic area sustains an injury through a fall or an accident or undergoes surgery, the pelvic muscles can spasm in response to the pain.
Holding Urine
Holding urine for too long can cause the pelvic floor muscles to remain tight for longer than they are used to. When this occurs repeatedly, it can become difficult for the pelvic floor muscles to relax, even after the bladder has been emptied.
Muscle Disorders or Dysfunction
Muscle disorders or dysfunction can be an underlying cause of pelvic muscle spasms. They can be genetic, due to uneven pelvic bones, irregular posture, or an abnormal gait. However, pelvic floor muscle spasms can also stem from sitting for too long at work, or from a sedentary lifestyle.
Pelvic Trauma
Both physical and psychological trauma can cause the pelvic floor muscles to spasm in protection mode. Referred to as vaginismus, it occurs when the pelvic & vaginal muscles are signaled by the brain to tighten in protection mode due to the fear of more pain or trauma.
Childbirth or pelvic injuries can often cause physical trauma, whereas psychological trauma can arise from rough sex, sexual abuse, or a belief that vaginal penetration will be painful.
Underlying Conditions
Conditions like a bladder infection or vaginal infection are sometimes known to cause pelvic floor muscles to spasm. Conditions that cause chronic pelvic pain or inflammation are also known to cause pelvic muscle spasms. These can include, but are not limited to; endometriosis, irritable bowel syndrome (IBS), vulvodynia, and fibromyalgia.
Nerve Damage
Nerve damage, as well as trapped nerves in the pelvic area, can interrupt the messages sent between the brain and the pelvic floor muscles, causing them to spasm and tighten involuntarily. Pudendal neuralgia is one example of a nerve compression condition that can cause pelvic pain.
Stress & Anxiety
Pelvic stress response, where the pelvic floor muscles tighten in response to physical or mental stress, can often be the cause of pelvic muscle spasms and pelvic pain.
Diagnosing Pelvic Floor Muscle Spasms
If you suspect you might be experiencing hypertonic pelvic floor, the first step is to schedule an appointment with your doctor or a pelvic physical therapist for a correct diagnosis. Experiencing issues or pain with urination, defecation, or intercourse could be a sign of pelvic floor dysfunction like pelvic muscle spasms. However, these issues could also be due to another condition, so it's important to rule them out.
To diagnose or rule out pelvic floor muscle spasms, your healthcare provider or physical therapist will typically ask about your symptoms. Even if speaking about urinary, defecation or sexual issues is difficult, it's important to be honest and open for a correct diagnosis and effective treatment.
The consultation may also include a pelvic exam to investigate how successfully you can tighten and relax the pelvic muscles on demand. Depending on these results, tests might also be performed to check how well the bladder and bowel function, as well as the contraction and relaxation of the sphincter muscles.
How to Treat Pelvic Floor Muscle Spasms?
The first line of treatment recommended for tight or spasming pelvic floor muscles is physical therapy, preferably with a physical therapist specializing in pelvic health. In addition to massaging, stretching, and relaxing the pelvic floor muscles, physical therapists also teach patients to retrain the pelvic floor to contract and relax the muscles correctly.
Depending on the extent of a patient’s condition, physical therapists also recommend some helpful tools like vaginal dilators and pelvic massage wands to continue healing at home.
Vaginal Dilators
Vaginal dilators are tube-shaped medical devices that come in various ascending sizes to help relax tight pelvic floor muscles and vaginal muscles slowly and gently. Patients are typically advised to begin with the smallest dilator (about the size of a female pinkie finger) and a generous amount of lube, then slowly progress through the set as per the advice of their physical therapist.
Pelvic Wands
Pelvic massage wands are ergonomically designed to easily slip into the vagina or rectum to reach deep-rooted trigger points in the pelvic floor. Here at Intimate Rose, we sell the only pelvic massage wand on the market that is made from soothing medical-grade silicone.
Either end can be used vaginally or rectally to empower people to address pelvic pain. There are 3 types of wands: Original, vibrating, and temperature therapy. Vibration has been shown to improve blood flow and relax the pelvic floor muscles, while temperature therapy is helpful in cold or warm temperatures to help calm irritated pelvic floor muscles.
Similar to vaginal dilators, pelvic wand massage helps to gently and slowly improve muscle flexibility and tissue elasticity for a gradual restoration of a healthy pelvic floor function.
Acupuncture
Acupuncture is an ancient Chinese medicine believed to stimulate the central nervous system and relieve pain by inserting tiny needles into strategic points in the body. For some people, regular acupuncture sessions are known to minimize constant or recurring pain.
Relaxation Techniques
Due to the pelvic stress response to chronic pain, learning to relax can also be of enormous benefit to women suffering from tight pelvic floor muscles. Yoga can help, as can diaphragmatically breathing, relaxation, and meditation.
Conclusion
Stabilizing the body and supporting the pelvic organs are the two main roles of the pelvic floor. When the pelvic floor muscles spasm or tighten due to injury, trauma, surgery, or underlying conditions, the pelvic organs and spinal support can suffer. This can cause issues with urination, defecation, and sex, as well as lower back and hip pain.
This condition is fixable and there is no shame in reaching out to your healthcare provider for help. It’s important to speak honestly with a healthcare provider about your symptoms to receive a correct diagnosis and effective treatment. In addition to physical therapy, vaginal dilator therapy, and pelvic wand massage can help relax the tight muscles.
References
Teach Me Anatomy - Pelvic Floor - https://teachmeanatomy.info/pelvis/muscles/pelvic-floor/
Cleveland Clinic – Hypertonic Pelvic Floor - https://my.clevelandclinic.org/health/diseases/22870-hypertonic-pelvic-floor
Endometriosis Foundation of America – Understanding the Different Stages of Endometriosis - https://www.endofound.org/stages-of-endometriosis
Web MD – Vaginismus - https://www.webmd.com/women/vaginismus-causes-symptoms-treatments
Mayo Clinic – Vulvodynia - https://www.mayoclinic.org/diseases-conditions/vulvodynia/symptoms-causes/syc-20353423
National Library of Medicine - Pelvic Floor and Urinary Distress in Women with Fibromyalgia - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571646/
Physiopedia - Impact of stress and cortisol levels on pelvic pain and pelvic stress reflex response - https://www.physiopedia.com/Impact_of_stress_and_cortisol_levels_on_pelvic_pain_and_pelvic_stress_reflex_response
The Pelvic Hub – Vaginal Dilator Therapy: What Exactly Is It? - https://www.thepelvichub.com/ask-the-experts/vaginal-dilator-therapy