Pain Meds or PT?

October is National Physical Therapy Month!

In honor of all that physical therapists do in helping their patients reduce pain, we will be discussing how PT can help you reduce the need for pain medication and improve your individual functional outcome.

Dealing with pain of any kind is hard.

Now, let’s talk about pelvic pain. The exact number of people dealing with chronic pelvic pain is uncertain. This is because the pain can be linked to so many different diagnoses and symptoms, such as dyspareunia, vulvodynia, and endometriosis. For this reason, the pain may be misdiagnosed as a variety of other conditions, making it hard to determine just how many people deal with chronic pelvic pain. (1) One study stated that around 15% of women of the child-bearing age in the USA had pelvic pain that lasted around 6 months.

painful bladder


Pelvic floor physical therapy (PFPT) can be a great first intervention or alternative to medication or surgery for myriad conditions including pelvic pain, incontinence, constipation, pelvic organ prolapse, and/or back pain. PFPT is a specialty practice in which a doctor of physical therapy has additional training to concentrate in abdominal and pelvic conditions.


Certain diagnoses can often have musculoskeletal involvement. For a woman suffering from endometriosis, this will cause severe pelvic pain and she will often have connective tissue restrictions, myofascial pain and muscular restrictions in all of the muscles around the pelvis as a result of that pain. In most cases, if the endometrial tissue is removed via laparoscopy, but the soft tissue restrictions remain, pain will not go away. As highly trained specialists, pelvic floor physical therapists can identify and remove soft tissue restrictions, adhesions between organs, and restore normal mobility of the abdomen and pelvis. That is to say, a multidisciplinary approach to pain tends to be the best to help people achieve optimal recovery.

Dr. Casey Smith with patient in room 1

PFPTs usually work very closely with surgeons and urogynecologists to help patients achieve optimal recovery. Surgery will often correct an anatomical problem, but it is important to have improved muscular control and function to help a person attain optimal outcomes after surgery. Research has shown that physical therapy prior to and after surgery improves patient outcomes as well as reduces the need for future surgery.

vag dilators

Constipation is a good example of a common condition that most people treat with medication, however, pelvic floor muscle tightness can be a cause or effect of chronic constipation and can be addressed with pelvic floor physical therapy. We use a variety of interventions to retrain individuals to improve their digestion and evacuation more naturally. The same muscles can also influence your urinary control and sexual function. PFPTs work with your doctor to optimize your recovery to balance medication, behavioral training, nutrition, and pelvic floor retraining



(1) Mathias, S. D., Kuppermann, M., Liberman, R. F., Lipschutz, R. C., & Steege, J. F. (1996). Chronic pelvic pain: Prevalence, health-related quality of life, and economic correlates. Obstetrics & Gynecology, 87,321–327.


Published by Dr. Cora T Huitt

Cora T. Huitt, PT, DPT, BCB-PMD ~Thirty seven years of clinical practice, specializing in women's health for fifteen years. ~BS Degree in Allied Health Professions, Ohio State University, '72. ~Master of Arts in College Teaching (MACT) focus in Physical Therapy & Therapeutic Exercise, University of North Carolina, '76. ~ Doctorate of Physical Therapy, Alabama State University, 2010 ~Attended multiple courses offered in Women's Health Physical Therapy, including Pelvic 1, 2, 3 Course in Women's Health Section APTA. ~Member of VPTA and APTA, Women's Health Section. ~BCIA-PMDB Biofeedback- Pelvic Muscle Dysfunction Biofeedback. ~Certified Pilates instructor, ProHealth. ~Affiliate member of the American College of Obstetrics and Gynecology. ~Member of International Continence Society. ~Member of National Vulvodynia Association. ~Adjunct Clinical Faculty for student affiliation at multiple universities. ~Director of APTA Women's Health Residency since 2007, credentialed in 2008. (only other residency at Duke Unviersity)

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