You want to put needles where??
Yes!! I can dry needle your pelvic floor! I know you are thinking it: “now why on earth would I ever want to do that?” Well, more and more research is coming out on how dry needling is a safe, quick, and effective treatment for muscle pain. And guess what? You have muscles in your pelvis – your pelvic floor! Pelvic floor dry needling is appropriate for many diagnoses we may see that involve the pelvic floor. These include pelvic pain, urinary incontinence, constipation, pudendal neuralgia, coccydynia, and even diastasis rectus abdominus.
With pelvic floor dry needling, a very thin, solid monofilament needle is inserted directly into the muscle belly. The muscle I choose to insert the needle into will depend on which muscle function I am trying to target and improve. And no, I’m not going “right up in there” with the needle. I actually take an outside to in approach. With a patient lying on their side, I will find their “sit bone” and place the needle directly inside of this. This is an easy place to access many of the pelvic floor muscles without going right up through the perineum.
I will also often use dry needling for other muscles that have a very close relationship to the pelvic floor. These include the lower back, TL junction (the part of your spine in your mid-back), glutes/hips, abdomen, and inner thigh muscles. Because all of these muscle groups work so closely with the pelvic floor, if we see dysfunction in one, we will often see dysfunction in the other. It is very important to assess and treat dysfunction in these muscles whenever we are treating the pelvic floor.
I know your next question: “does this hurt?” I am not going to tell you that it is discomfort-free. However, I would not call it “painful.” There is usually a little bit of discomfort once the needle is inserted into the muscle belly. To me, it feels like a deep muscle ache, others describe it as a muscle “grab”. The good thing is that is short lived. (Yes, I have had dry needling to my own pelvic floor done; I know exactly how it feels!) Once this deep ache resolves, the patient will typically feel nothing! I even have some patients that prefer dry needling to traditional pelvic floor manual therapy because they found the dry needling more comfortable!
The other exciting part of this all is that I can use a small hand-held device to apply electric stimulation directly into the muscle! Why is this helpful? Well, when we apply electric stimulation into the dysfunctional muscle, we see a “reset” of the muscle and surrounding nerve structures. This “reset” can help a tight muscle relax, or help a weak muscle “wake up” in order to make strengthening exercises more effective! Current research is supporting the application of electrical stimulation along with dry needling and finding this to be more effective than dry needling alone in some areas of the body. The electrical stim does not hurt. Rather, you will feel a deep “thump” in the pelvic muscles. The nice thing about this treatment is that the intensity of the electrical stimulation is totally driven by you, the patient! I only turn up the intensity to a level that is comfortable.
So yes, I do want to place needles down there!
Pelvic floor dry needling can be a very effective treatment tool to help resolve any pelvic floor muscle dysfunction we may be working with. This will ultimately allow you to live your best life!