Chronic Pelvic Pain

Chronic pelvic pain syndrome or persistent pelvic pain syndrome, is pain or altered sensation in the pelvic region, which is the lower part of your abdomen and pelvis. It is a common condition, as common as asthma, migraine and low back pain, and affects mainly women, of reproductive age, although men can also be affected to.  It can be a symptom of a condition or a condition itself, and therefore sometimes its causes can be unclear.

Symptoms can vary and you may experience intermittent, steady or severe pain, a constant or intermittent dull ache in the abdomen, pelvis or low back region. In addition, you experience altered sensation during intercourse, when urinating, standing or sitting for a long period of time or when having a bowel movement.

Why can the pelvic floor be a source of discomfort and pain within the abdomen and pelvis?

Straining of childbirth or constipation, a fall on your tailbone, hyper-mobility, thyroid disease or inflammatory problem within the pelvis can all lead to the development of persistent pelvic pain. Repetitive activities such as running, horse riding or riding a bike can exacerbate the situation.

It is common for symptoms to build up over many years before you are aware there is a problem. Sometimes the symptoms you feel are difficult to locate in your body and it is not always clear where you think you are experiencing symptoms.

 Common symptoms include some or a few of the following:

  • Pain in the front or bottom of your pelvis when sitting
  • Exercise induced abdominal, pelvic or low back pain
  • Urination frequency, hesitancy, pain, burning and or urine incontinence
  • Decreased for of stream with urination
  • Constipation
  • Abdominal pain
  • Hip pain
  • Low back pain – click here
  • Painful periods

What can be done?

Soft tissue and joint techniques are used to ease tension in the low back, abdomen, hips and pelvis, whilst other areas associated with your symptoms can be treated for mobility and pain issues.

During an assessment a personalised treatment plan is put together for you based on your medical history, cause of your condition and level of symptoms. During the treatment specific muscles will be targeted, such as your low back muscles, pelvic floor muscles, abdominals, hips and thigh muscles to ease the tension within them. As you improve, you will be taught exercises that you can do on your own to improve your heath.



Leon Chaitow D.O. N.D. was a world renowned university lecturer and author in the field of Osteopathy, he was also an Osteopathic practitioner. Click here to view a film of Leon Chaitow giving a lecture to Osteopaths on the subject and treatment of chronic pelvic pain.

Click here for a very useful film that describes the anatomy of the pelvic floor in great detail using a 3D anatomical model of the pelvis.

Click here for a film showing some exercises that can help. It is advisable that you have a discussion with me before undertaking these exercises.


Ask in clinic to read an evidence based article written by Leon Chaitow in The Journal of Bodywork Movement Therapies. 2007. Chronic Pelvic Pain: Pelvic Floor Problems, Sacroiliac Dysfunction and the Trigger Point Connection.

Click here Click here for a PDF describing the neuroanatomy of female pelvic pain written by Professor Frank Willard Ph.D. Department of Anatomy, College of Osteopathic Medicine, University of New England. USA. Please be aware this document contains photographs of human dissection as the subject matter is aimed at medically trained clinicians.


D Wise, PhD & R Anderson, M.D. A Headache in the Pelvis: A new understanding and treatment for chronic pelvic pain syndromes. National Centre for Pelvic Pain (USA). 2014.

ISBN: 978-0-9727755-5-7

S A Prendergast & E H Rummer. Pelvic Pain Explained. What everyone needs to know. Rowman & Littlefield. 2016.

ISBN paper: 978-1-4422-4832-8. ISBN electronic: 978-1-4422-4832-8

Information and support

Osteopath is a registered title only given to those who have taken the right training and fulfilled the criteria set out by the General Osteopathic Council (GOsC).  It is a criminal offence for anyone not registered with the GOsC to use the title of Osteopath. Osteopaths have to work within a code of conduct framework, please access the PDF document below for detailed information on those practice standards.

Dr Miriam O’Kane – Gynaecologist

As a medical professional I have treated many patients with pelvic pain. Where conventional medicine works for many patients, there are many others for whom painkillers and surgery are not the answer, including myself.

Dominic’s fresh approach to the management of pelvic pain is both evidence-based and holistic. He has an in-depth understanding of pelvic anatomy that underpins his rationale for this management, and is able to use this to guide his practice and tailor treatment according to my individual needs. I found this very reassuring. His manner is always professional and he takes time throughout the consultation to explain what he is doing and to check that I feel comfortable to proceed.

Whether or not pelvic floor dysfunction is the underlying cause of most cases of lower back pain or pelvic pain is debatable, but I certainly think it is a reasonable option for those searching for a way to manage chronic pain, and therefore worth considering. In an ideal world there would be a multidisciplinary team comprising gynaecologists, physiotherapists, counsellors and osteopaths like Dominic to ensure that those suffering with pelvic pain get the appropriate treatment, rather than just the treatment each individual can offer”.

Hollie Brunton – Nurse R.G.N.

Dominic Fieldus is a very experienced Osteopath with many years of practice behind him. He is very different to any other Osteopaths I have seen in the past. Dominic has a very holistic approach to both assessment and treatment. I feel this is very important because he assesses the individual as a whole not just focusing on the apparent problem e.g. “back pain”.

Pain can be multifaceted and be the result of symptoms referring from or radiating from another area of the body. The way Dominic assesses and treats he considers other factors which can be contributing to the pain experienced.  Dominic is extremely skilled, he can often locate the area of my discomfort just by looking at my posture and the tension within the body before I even say where I am experiencing pain.  Dominic is not your stereo-typical Osteopath who just “clicks” areas of the body. He rarely does this as he has experienced through many years of practice that this often doesn’t help him to resolve problems and pain experienced.    

Pelvic pain is often an area that is not treated because clinicians are unsure of this area and don’t feel confident to approach it. Dominic has treating this area for many years now.  Dominic is always updating his knowledge and regularly attends training to develop his knowledge further. Dominic treats pelvic pain for both men and women.  

In the past I often thought I had just back pain but now realise that actually it radiates from my congested pelvis. It still fascinates me how Dominic can locate the region that is congested. After treatment I feel much lighter and no longer feel as though I am carrying around a heavy weight, I feel I can move more freely. 

My condition Ehlers Danlos Syndrome type 3 is not curable but is managed by regular treatments  by Dominic. At times I have been in so much pain I could barley walk, after seeing Dominic my symptoms are greatly reduced. 

I have been going to Dominic for many years after being recommended by a friend. He is extremely professional and is so much more than just an ‘Osteopath’! He offers advice regarding diet, exercise, how to keep well both with physical and mental health.  

I highly recommend Dominic for his excellent treatment and such a professional manner. 

Some of my patients are happy to discuss what to expect during treatment of chronic pelvic pain so please feel free to email them for a ‘patient’s perspective’ on this subject. I can provide you with their email address on request. 

Madison Beckett. 

Rachel Spinetti. 

Elizabeth Cornwell. 


Osteopathic Practice Standards Public Document