Patients sometimes feel embarrassed at first by the hands-on physical therapy (PT) techniques used to treat vulvodynia (VVD) and other chronic pelvic pain conditions—but this fades quickly as the techniques bring significant relief. How PT works…

In response to the chronic pain of VVD, the muscles of the pelvic floor tighten uncontrollably and eventually go into spasm. This exhausts the muscles and allows the buildup of lactic acid, thereby causing additional discomfort. To relax muscles and reduce spasms, a physical therapist may use...

  • External manipulation. The therapist gently rubs and kneads the patient's pelvic region, hips, thighs and abdomen...and teaches the patient to do this technique herself
  • Internal manipulation. With a finger, the therapist gently stretches tight vaginal muscles. The patient also learns to do this herself.
  • Electrostimulation. A device delivers an electrical current via sensors placed on the vulva or inside the vagina, producing controlled muscle contractions that ease spasms.
  • Biofeedback. Sensors placed on the vulva help the patient recognize when she is succeeding at relaxing specific muscles.

The majority of VVD patients are treated successfully within six to 20 sessions of 30 to 50 minutes each, spread over several weeks or months. If PT is prescribed by a doctor, insurance generally covers it.

Referrals: American Physical Therapy Association, 800-999-2782,

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