Pelvic - Abdominal Pain Trigger Points
Trigger Point Therapy for Pelvic Pain, Abdominal Pain, and Genitalia Pain
The fact that pelvic pain could be caused by trigger points astonishes most people. There exists a stubborn belief that pelvic and abdominal pain (and cramping) is always related to a problem with the body's internal organs.
Menstrual cramping, in particular, is always blamed on "natural" hormonal changes, or if severe enough, blamed on endometriosis or ovarian disease. The hormone changes associated with a woman's cycle, frequently activate trigger points by changing the fluid balance and mineral concentration of the body. While this effects all the muscle groups of the body, it seems to activate the trigger points in the abdomen and neck regions to a greater degree.
Pelvic pain associated with sexual intercourse typically occurs due to an overloading of the abdominal and thigh muscles. The trigger points that are activated by this muscular overload, refer pain deep in the pelvis and abdomen for hours and even days afterward.
The following muscle groups can contain trigger points that produce pain and cramping in the pelvis and abdomen:
The Adductor Magnus Trigger Points that Cause Pelvic Pain
The Adductor Magnus is a large muscle group found deep in the inner thigh region. This muscle attaches to the pelvis and runs downward to attach at several places along the large thigh bone (the femur). This muscle contracts to rotate and swing the thigh inwardly (towards the other leg).
Trigger points in this muscle can refer pain to the groin or inner thigh region. One particular trigger point may also refer pain that is felt inside the pelvis, genitalia, or rectum.
Adductor Magnus Trigger Point Symptoms
Patients with active adductor magnus trigger points will complain of pain that feels deep inside the pelvis. Unlike most trigger point referred pain that is aching in nature, this pelvic pain manifests as a sharp, lightening bolt-like type of pain.
In women, this trigger point is frequently active during times of severe menstrual cramping, and during and/or after sexual intercourse. In men, this trigger point activity is experienced as testicular pain.
Adductor Magnus trigger points can also refer pain to the groin and inner thigh regions.
The Abdominal Oblique Trigger Points that Cause Pelvic Pain and Abdominal Pain
The Abdominal Oblique muscles form the outer abdominal wall in the stomach region. The two major muscles in this group are the external oblique and the internal oblique. They attach to the ribs, pelvis, and to other abdominal muscles via a large sheet of connective tissue. This muscle group contracts to stabilize the trunk, and to flex and/or rotate the trunk to either side.
Trigger points in this muscle group can refer pain to the lower abdomen, pelvis, groin, and genitalia.
Abdominal Oblique Trigger Point Symptoms
Patients with active oblique trigger points may complain of pain in the epigastric (above the stomach) region, resembling heartburn or hiatal hernia.
The may also complain of pelvic pain, groin pain, and testicular or vaginal pain. These trigger points may also produce gastrointestinal symptoms such as belching, abdominal bloating, and diarrhea.
The Rectus Abdominis Trigger Points that Cause Abdominal Pain and Pelvic Pain
The Rectus Abdominis muscle is the "six-pack" muscle group in the stomach region. It attaches to the breast bone and adjacent ribs, and runs downward to attach to the pelvis. This muscle contracts to flex or curl the trunk on the pelvis, and helps stabilize the trunk during upright activities.
Trigger Points in this muscle group can refer pain to the belt-line, across the mid back, and at very places in the stomach region. Additionally, the trigger points may produce such diverse symptoms such as, abdominal bloating, heartburn, nausea, and may even resemble the pain associated with appendicitis.
Rectus Abdominis Trigger Point Symptoms
Patients with active lower rectus abdominis trigger points will present with low back pain across the belt-line and in both sacroiliac joints. If the upper trigger point in this muscle is active then they will complain of mid-back pain across the base of the rib cage.
I've had some patients come to me with active rectus abdominis trigger points that have no back pain component of their symptoms. These patients complain of various types of abdominal and pelvic pain. Some patients have both abdominal and back pain symptoms. The symptoms depend on which trigger points (or all) are active.
The lateral trigger point in this muscle can produce lateral abdominal pain that mimics appendicitis if it's on the patient's right side. The mid trigger point(s) produce pelvic pain and testicular or vaginal pain.
Other symptoms include abdominal pressure or bloating, nausea, gall bladder attack, heartburn, and painful menstruation.
Secondary Trigger Points that Cause Abdominal Pain
Two other muscle groups can refer pain to the abdomen and the groin regions, though they are more famous for causing low back pain complaints. For this reason I consider them as secondary trigger point for abdominal pain complaints.
The first is the quadratus lumborum trigger points, which may extend their pain referral around the hip and into the pelvis and groin. The second is the lumbar multifidi trigger points that refer pain primarily to the lumbar spine itself, but can also refer pain to the lateral abdominal region. You can learn more about these trigger points by watching their videos.
Related Instructional Videos from Dr. Perry
While the videos below were created to teach therapists how to locate and release these trigger points, many non-professionals have used them to learn these techniques successfully.
If you have a partner, a little time, you can use these videos to learn how to treat your own trigger points.
Related Articles from Dr. Perry
More extensive articles on these muscles and trigger points are available from Dr. Perry on our sister website TriggerPointTherapist.com. Click on the titles below to read them: