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Chronic Pelvic Pain and Stress

It seems that we are all stressed these days—over busy with work, kids, home management, the world’s ills.  Our bodies and brains are changed by the constant barrage of stressful stimuli and can cause a cycle that is difficult to break.  It is important to understand how stress affects our lives and also how it plays into the chronic pelvic pain cycle.

What is Chronic Pelvic Pain?

Many of my clients see me because of chronic pelvic pain diagnoses.  The pelvic pain often begins with an acute cause. Endometriosis, IBS, pelvic muscle pain after childbirth, a traumatic event can also cause pelvic pain.  Our brain interprets this pain as a threat.  As the pain continues, the threshold of a stimulus that would normally be non-painful, becomes painful.  This can mean that wearing jeans, sitting for a short period of time, or a tampon becomes painful and may not be tolerable.

If you have an episiotomy, there is an acute cause of the pain and your nervous system will be heightened while your pelvic floor muscles are  healing.  However,  if your nervous system continues in this heightened state, your nervous system will transition into the chronic pain cycle.  This is when wearing underwear, having a bowel movement or sitting for a few minutes continues to be painful long after the initial injury has healed.

Chronic Pelvic Pain and Stress

Once the nervous system is in a heightened state, pain can change or increase with stress, financial concerns, or the anxiety of not having a clear reason for the pain.  Understanding that outside stressors can contribute to pain helps to break into the pain cycle.  It also helps to down train the nervous system and its alarm system.  Some good options for starting to down train the nervous system’s alarm network include aerobic exercise and diaphragmatic breathing. Meditation or mindfulness, or journaling, are also important.


When I am working with someone who has chronic pelvic pain, one of the first things I educate my patients about is how the brain and body are connected. We also discuss how our brain changes with the long term input of painful stimuli.  I will next have my patient begin some nervous system down training as the beginning of a home exercise program.  Sometimes, adding a mental health professional who specializes in working with chronic pain is a wonderful addition.  Clients who work with a mental health professional and physical therapist tend to improve more quickly.


As we all continue to learn how stress affect our brains and bodies, it is exciting that we are able to start taking control of how our brains and bodies affect each other.  Stop Breath and Think and Headspace are 2 of my favorite meditation apps for smartphones. I’ve also linked to a sample gratitude journal so you have a place to start:  Activites to enhance positive affect

If you are struggling with chronic pain, particularly chronic pelvic pain, there is hope.

Jenn Cumming PT, MSPT, CLT, WCS

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