When people hear the words pelvic pain, they often think of gynecological conditions, endometriosis, adenomyosis, fibroids, scar tissues, bladder issues and bowel problems.
What isn’t talked about enough is Myofascial Pelvic Pain Syndrome (MPPS) it is a chronic pain condition rooted not in the organs, but in the muscles that support them.
I live with this condition, and it shapes daily life in ways that are invisible from the outside. It’s not just “a sore muscle.” It’s a cycle of tension, pain, and exhaustion that affects the body, mind, and spirit.
I live with Pudendal Neuralgia after having adenomyosis removed via a partial hysterectomy then a year later endometriosis removed via laparoscopic surgery this left me with muscular damage and nerve damage (pudendal neuralgia) then I found out I also had a very painful condition called Myofascial Pelvic Pain Syndrome this came about after an examination of the upper vaginal area (near the cervix to give clarity on the area) I had four nodules inflamed spots measuring about 4mm’s which where incredibly painful to be touched.
I had a steroid injection for my pudendal nerve and one in each nodule (myofascial trigger points) via my gynocologist who diagnosed me with this condition and pudendal neuralgia
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He literally put my mind at ease giving me a name to my pain, to those who have experienced a diagnosis after years of gaslighting and being told it’s in your head. Acknowledgment of our suffering with diagnosis means so much truly. Then the work can begin on our conditions.
It was so painful to get the steroid block I needed for the pudendal nerve internally (vaginally) and then the injection in the growing knots/nodules as well all at the same time. I could barely walk or sit afterward. I couldn’t drive, it took three weeks for the pain and flare from the injections to subside.
Ive had this same block for the pudendal nerve and myofascial trigger points three times. Once every six months
Does it work?
Yes, it reduces the inflammation of the trigger points and the nerve pain by 60/70% for a period of time steroid blocks are temporary and don’t last for long periods maybe four to six months if Im lucky.
You will know when it wears off…
What Is Myofascial Pelvic Pain Syndrome?
Myofascial pelvic pain syndrome is a form of chronic pelvic pain caused by trigger points tight, irritable muscular knots in the pelvic floor and surrounding muscles.
These trigger points behave differently than ordinary muscle soreness:
They refer pain to other areas hips, groin, lower back, bowel or the bladder.
They can cause pain that feels like burning, stabbing, aching, or pressure. Very similar to Pudendal Neuralgia but its muscular not nerve related.
They may make everyday activities like sitting, exercising, or intimacy difficult.
In short, MPPS is a muscular problem that can feel like nerve pain or organ pain—making it confusing to diagnose it took me nearly two years to make the discovery due to the lack of knowledge surrounding this diagnosis.
Symptoms of Myofascial Pelvic Pain Syndrome
From my experience (and what’s supported by research), symptoms can include:
Sharp or stabbing pelvic pain
Burning, aching, or throbbing
Pain when pressure is applied to specific points
Pain that radiates into the hips, back, abdomen, or thighs
Discomfort with sitting for long periods
Bladder or bowel pain that isn’t explained by infection
Feeling like you have a hard area of pain in your pelvic area like inflammation it hurts to breath or move
For me, the pain is unpredictable, some days it’s a dull background ache, other days it’s so sharp it stops me mid-sentence
What Causes Pelvic Muscle Trigger Points?
There isn’t one single cause. For many people, it develops after a combination of factors such as:
Pelvic surgery or injury (muscles go into protective spasm)
Childbirth or trauma to pelvic tissues
Chronic tension and stress (the pelvic floor is highly reactive to stress)
Posture and muscle imbalances
Surgery’s pelvically
Trauma to the vagina
Other pelvic conditions (like endometriosis, adenomyosis, or interstitial cystitis)
In my case, multiple surgeries and years of muscle tension seemed to create the “perfect storm” for trigger points to take hold.
Living With the Daily Impact
Chronic muscle pain in such a private area isn’t easy to explain. It’s invisible to others, but it changes everything: how long I can sit, what activities I can do, and even my energy for simple daily tasks it can leave me exhausted which is frustrating at the best of times.
The hardest part isn’t always the pain itself it’s the dismissal. Too often my pelvic pain got brushed off as anxiety, stress, or “in my head.” Stress makes it worse, yes but stress isn’t the cause.
This is a real, physical condition.
Treatment Options
There isn’t a one-size-fits-all cure, but there are effective management options. What helps me (and others) includes:
Pelvic floor physiotherapy, Specialised physios can release trigger points manually and teach relaxation techniques.
Trigger point injections, Direct treatment into stubborn muscle knots.
Medication – Pain relief or muscle relaxants can be part of the plan.
Self-care & lifestyle – Heat packs, gentle stretching, pacing activity, and relaxation practices.
Stress reduction – Not a cure, but reducing stress helps muscles unclench and lowers pain flares.
It took trial and error to find what worked for me. The key was building a care team that listened.
The Emotional Side
Chronic pain is never just physical. Living with myofascial pelvic pain means learning to grieve the “old normal,” while also carving out a new one. Some days, I feel strong and capable. Other days, I feel exhausted and overwhelmed by pain.
Over time, I’ve realized that needing help isn’t weakness. My body isn’t broken—it’s just asking for care. And meeting that need is an act of resilience, not failure.
Breaking the Silence
The more we talk about myofascial pelvic pain, the less alone people feel when they hear the diagnosis for the first time. Awareness matters. Too many suffer in silence because pelvic pain is still seen as “taboo.”
💜 If you live with this, you are not alone.
💜 If you’re searching for answers, your pain is real.
💜 If you’re supporting someone, your compassion matters more than you know.
My Thoughts
Myofascial pelvic pain syndrome is challenging, but it’s not hopeless. With the right support, treatment, and understanding, it’s possible to find relief, build resilience, and reclaim joy, even between the trigger points.
If you’ve been searching for answers, know this: your pain is real, and help exists. Myofascial pelvic pain may be hidden, but together we can bring it into the light
Cassie x
Welcome Beautiful 