Chronic Pelvic Pain (CPP) is a condition where persistent or recurrent episodes of pain is experienced in the abdomen, pelvic region, pelvic floor or pelvic organs. It has been present for more that 6 months duration, often associated with discomfort in bladder or bowel, emptying, sexual pain and usually in the absence of organic aetiology.

CPP can be a debilitating condition that affects 15-20% of women ages 18-50 worldwide. CPP is multifactorial in nature therefore underlying causes can be due to multiple mechanisms:

  • Ongoing acute pain mechanisms (inflammation/infection)

  • Up regulation of the peripheral or central nervous systems

  • Psychosocial factors (emotional, behavioural, cognitive responses) or predisposing factors (genetics, general health, past experiences)

CPP covers a vast array of symptoms and signs therefore assessment and evaluation is paramount to assist with diagnosis and treatment.

Common Chronic Pelvic Pain conditions are endometriosis, bladder pain syndrome, interstitial cystitis, pelvic floor muscle pain, coccydynia, vulvodynia, anal pain syndromes, pudendal neuralgia.



Due to the complex nature of CPP treatment approaches vary greatly. Our approach at WIF is to do a very thorough assessment taking into account all events that may have led a woman to experience CPP and all biomechanical and psychosocial factors that have prevented the pain from resolving.

Once we have a good idea of the nature of the pain, the drivers and pain generators we will then create a detailed treatment plan to help the woman both through physiotherapy and lifestyle changes.

Physiotherapy treatment techniques often used include:

  • Optimising breathing patterns

  • Pelvic floor down training and desensitisation

  • Graduated pelvic floor release and manual therapy.

  • Guided dilator therapy

  • Defecation dynamics

  • Down regulation of central nervous system drivers

  • Musculoskeletal assessment and treatment, in particular looking at the thorax, abdomen and pelvis

In many cases we will work alongside other health practitioners and refer on for scans, medication or in some cases for further intervention such as Botox injections or surgery if deemed necessary.

Conservative treatment with a specialised women’s health Physiotherapist with experience in treating CPP is highly effective and should be the first line management before intervention is trialled.