That Burning Sensation Down There May Not Be An Infection — And What To Do If Meds Don’t Help

That Burning Sensation Down There May Not Be An Infection — And What To Do If Meds Don’t Help

April 14, 2022

A patient comes to our office with a diagnosis of chronic bladder infection, yeast infection, or vaginal bacterial infection and they also happen to have pelvic pain.  The antibiotics or yeast medication sometimes works, but more often does not and they are frustrated.  When I ask them about confirming the diagnosis with a positive culture, they often report that they don’t always get a test or the urine culture comes back negative for infection.

As a pelvic PT, I’ve heard this story many times.  And sadly, it’s often years before they are referred to or find a pelvic PT for an assessment.  Most of the time, we do find that they have a LOT of pelvic floor muscle tension, pain, and inability to relax their muscles.  And their description of pain is often of a burning or sharp sensation with very light palpation pressure with a single gloved index finger.

This is a classic case of pelvic floor muscle dysfunction and pain.  However, the report of BURNING to a doctor often leads them to suspect infection. This is what they are trained to suspect.  But to a pelvic PT, the three main descriptions of pelvic pain with light pelvic floor muscle palpation are BURNING, PINCHING, or SHARP sensation. NEVER ACHING.

After almost 12 years of pelvic floor specialization, I have never had a patient describe their pelvic pain with anything other than the three descriptions above.  So below are the steps I recommend you take to get closer to resolving your discomfort.

1.   Be sure that IF you are prescribed a medication, a positive culture for bacteria or yeast has been found.

2.   If no positive culture, discuss this with your doctor before taking medications and ask for help with finding other sources of the pain which can be ruled out with a pelvic PT.

3.   Make note of times symptoms are worse.  Does pain increase with prolonged activities like sitting, running, or intimacy.

4.   Is there any delay in being able to empty your bladder or bowels? If so, start the habit of taking SLOW belly breaths in and out for 4 counts each way 5-10 times each toilet trip.  This can help your nervous system and pelvic floor muscles calm down and help you better empty without straining.

5.   Try getting into a happy baby or child’s pose (yoga poses) and take slow belly breaths for at least 1-3 minutes.  Try to relax your belly with each inhale.  This can work to reduce the fight or flight nervous system that can increase overall body tension and these two poses are both ones that place the pelvic floor muscles in a more lengthened position.  

6.   Connect with a pelvic floor physical therapist in your area.  Know that many even have virtual consults that can be done to help confirm if they may be of help and put you at ease with the concept of working with someone that may be assessing your pelvic floor in the future.  We can also be a good resource to help you find other providers in the area if we don’t feel that we can be of help.

When it comes to pelvic pain, pelvic physical therapists are ALL about it.  We KNOW pelvic pain patterns, how the pain manifests, how it is described by our patients, and most importantly we KNOW how to help you resolve it!  We are able to play detective and help each patient figure out the root cause of their pain so that we can resolve it for good.

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