Vaginal Pain from pelvic and spinal ligament injury
Vaginal pain can develop from many causes. This article will focus on supportive ligament injury in the vaginal, pelvic, hip, and low back areas.
Some of the most heartbreaking chronic pain cases involve vaginal pain. Patients who deal with this pain are brave. Many tell us of the difficulty of going from doctor to doctor explaining problems that involve their most intimate bodily functions from painful orgasms to frequent urination and being given numerous prescription pills that chase the symptoms, until finally, they are called “crazy” or “depressed” and counseling is recommended. It’s very sad.
It can disrupt work, sports, marriages, childbearing, household duties and bring a constant awareness of pain or pressure that begins to rule a person’s life. Just finding a comfortable position can be difficult, as any adjustment may put pressure on different areas and cause a different type of pain.
There are many different causes of vaginal pain, including both structural and non-structural. Non-structural vaginal pain may be caused by an inflammation of the vagina, known as vaginitis, which could be due to a bacterial or yeast infection, or a sexually transmitted disease. It can also be caused by vaginismus, which is pain that occurs when anything enters the vagina. Irritation from hygiene or birth control aids, infections, scars from an injury or surgery, or childbirth may also account for vaginal pain.
In addition, chronic, lingering pain felt deep in the vagina, and often accompanied by pain in the lower back, pelvic area, uterus or bladder, may be caused by medical problems such as pelvic inflammatory disease; endometriosis; a pelvic tumor; bowel or bladder disease, such as interstitial cystitis; scar tissue; or ovarian cysts.
It can disrupt work, sports, marriages, childbearing, household duties with a constant awareness of pain or pressure that begins to rule a person’s life. Just finding a comfortable position can be difficult as any adjustment may put pressure on different areas and cause a different type of pain.
It is interesting to hear the diagnoses people have been given for their conditions. One particularly memorable patient was very happy that someone had finally given her a diagnosis for her pain: vulvodynia. She was crushed when she was told that this meant nothing more than vaginal pain. Vulva means vaginal and dynia means pain. All the doctor did was tell her something she already knew. She had vaginal pain.
If vaginal pain lingers and no known source is found, injured, loose or weak ligaments may be the cause
Doctors at the University of Hannover, in Munich have published new findings in the journal Current opinion in urology that suggests that surgery may represent a possible cure chronic pelvic pain, bladder and bowel dysfunction. The secret they say are the pelvic ligaments.
The purpose of their study was to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction (hemorrhoids, tears, fistulas, or abscesses) and pelvic organ prolapse (POP – the bladder drops and presses on the vaginal walls) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments.
In their study the German team provided evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years.
Laxity in ligaments (instability in the vaginal region caused by ligament damage and degeneration) and/or vaginal membrane due to damaged connective tissue may prevent the normal opening and closure mechanism of urethra and anus, because muscles need finite lengths to contract properly. Hypermobility of the vaginal apex (the uterus and cervix in women who have not undergone a hysterectomy, and the uterus and vaginal wall in women who have), can irritate the pelvic plexus (the nerve branches of the pelvic region) causing chronic pelvic pain. In consequence, dysfunctions as abnormal emptying of the bladder, urgency, pelvic pain, fecal incontinence and obstructed defecation can occur in women with different degrees of POP.
The researchers concluded that women bothered by these symptoms should be advised for possibility of cure by pelvic floor ligament repair surgery.1
At Caring Medical, we frequently find patients with chronic pelvic pain have underlying and unresolved ligament laxity. As opposed to surgery, we off non-surgical repair of the pelvic ligaments.
Vaginal pain that has not responded to surgery or conservative treatments may become classified as chronic and with unknown origin. If an underlying cause cannot be found, patients are often advised to continue with anti-inflammatory medications or steroid shots to control their pain. While these treatments may help temporarily, cortisone shots and NSAIDs can both result in long term loss of function.
When chronic vaginal pain cannot be resolved, ligament laxity may be the culprit. Ligament laxity can occur after a sudden injury to the low back or pelvic floor or after childbirth. During pregnancy, a hormone called relaxin is released inside the body to help relax the ligaments along the pelvic floor to better allow the baby to pass through the birth canal. It is not unheard of for women to be left with chronic vaginal or pelvic floor pain after childbirth that is related to loose ligaments.
In many cases, the iliolumbar ligament and/or sacrococcygeal ligament in the low back is involved. These weak ligaments can refer pain around to the groin or vagina and cause chronic agony. Thus, a better approach to chronic vaginal pain is to stimulate the repair of these ligaments with Prolotherapy. Once the weakened tissues are identified and strengthened, chronic pain in the vagina usually abates.
Numerous ligaments surround the pelvis and help to keep it stabilized. When these ligaments become weak, they are unable to maintain pelvic stability and can cause pain. They may also be tender to palpation (touch). Patients with chronic pelvic pain are frequently tender over the pubic symphysis or sacroiliac joints, often signifying weakened ligament tissue.
For chronic vaginal pain due to ligament or tendon weakness, Prolotherapy is an effective treatment option. Prolotherapy is a regeneration injection therapy (RIT) that stimulates the body to repair injured tissues and painful areas. Thus, the pain radiating into the vagina and other pelvic floor areas can be eliminated.
Please see our related articles:
- Pelvic Floor Dysfunction – New research is not only suggesting a high risk of Pelvic Floor Dysfunction in women who give childbirth and suffer from obesity, but also in high-level female athletes.
- Pelvic and Spinal instability from the facet joint – Doctors have released new research in which they investigated the relation between the structures of the low back, sacrum, and pelvis and how degenerating facet joints influenced lower spine instability.
- Symphysis Pubis Dysfunction Treatment – Recent research confirms what we hear from patients following childbirth who suffer from Pelvic Girdle Pain (PGP) or Symphysis Pubis
We can help chronic vaginal and pelvic floor pain
In our office, we have success treating a lot of pain in the pelvic, groin, and vaginal region in women who have chronic pain. Our Comprehensive Prolotherapy approach typically requires three to six treatments, given approximately one month apart. For an athlete or new mom, this type of treatment is ideal because it does not require needing to take medications and allows the woman to remain active, and encourages motion and exercise, between treatments.
Prolotherapy of the iliolumbar ligament can be curative for chronic groin, testicular, vaginal pain, and symptoms associated with pelvic floor dysfunction.
Prolotherapy to the pelvis involves a dextrose injection treatment to any of the numerous ligaments that may be weak and causing the pelvic instability. This treatment initiates a mild inflammatory response in the treated pelvic area. D-glucose (also called dextrose) is the normal sugar in the body, and when injected activates the immune system. The body’s normal healing inflammatory reaction boosts the blood flow to the area and attracts immune cells to the weakened or injured ligaments being treated. These cells will cause regeneration and strengthening of the injured areas. Once the ligaments are strengthened, the pelvis becomes stabilized. Referral pain will stop, contracted muscles will relax, and the chronic pelvic pain will abate.
1 Liedl B, Goeschen K, Durner L. Current treatment of pelvic organ prolapse correlated with chronic pelvic pain, bladder and bowel dysfunction. Current opinion in urology. 2017 May 1;27(3):274-81. [Pubmed] [Google Scholar]