It’s not a new idea to me that patients sometimes balk as treatments they have never heard of or don’t believe in.
I saw a patient just a few days ago with clear pelvic floor spasm. It is unusual for me to see someone with this as their only problem. But really, she had absolutely nothing else that was identifiable at the time of the visit.
So, I explained to her her the nature of the abnormality, the possibility of progression and of the difficulty of treating this problem. I had recommended physical therapy to her as the main modality of initial treatment. I took several attempts but I was finally able to explain to her that just like any other muscle in your body, the muscles of the pelvic floor can become spastic for a variety of reasons. She finally agreed to give it a try. I reassured her that all the physical therapists we use are experts in the pelvic floor and very experienced.
Most of the time when there is pelvic floor dysfunction it is secondary to another problem. That other problem may be a persistent problem such as endometriosis or an acute problem that has already been resolved such as a urinary tract infection. In either case, the pelvic floor muscles are acting to protect the underlying tissue from a perceived injury (as they would do with a broken bone for example). This spasm can long outlast the initial injury and become a chronic problem independent of the initial injury.
I have been recommending pelvic floor physical therapy to patients with many different types of underlying pelvic pain problems. This is often a critical adjunctive therapy (and sometimes the primary therapy) used to help patients improve their overall pain picture and improve their quality of life.
I hope this helps to better explain the need for physical therapy for certain pelvic pain conditions.