A particular feature of my PP is morning waking with pain. It is mostly gone within 30 mins if I move around but don't sit down. Ideas?

[Casablanca]

I have had this pain for about 6 years, I suspect I have always had a tendency to tightness in my pelvic floor but a series of pelvic surgeries brought it to the fore. On palpation though vagina I have trigger points on the left side of pelvic floor which may be associated with' twist' in pelvic bones.It has not responded to injections of local anaesthetic and cortisone. I am considering having botox injection but concerned it will increase stress incontinence. It seems to be triggered by lying in the one place and sleeping soundly but could it be caused by involuntary clenching of pelvic muscles as some people clench their teeth when asleep? I nearly always wake with this pain but if I didn't have to sleep or could sleep in a chair I wouldn't have CPP!

[PPSN_JudyB Pelvic Pain Support Netwo]

Just wondering whether you have had any physio for this ?

[Casablanca in reply to PPSN_JudyB]

I have had physio which has helped a little but my particular symptoms seem to be a mystery to most people I've been to. A pelvic floor physio has given me internal stretch exercises to do which are sometimes helpful but also just as likely to cause a flare up. Doing external stretch exercises helps. I have wondered re 'pelvic congestion' but I am now post menopasal and it seems to apply to pre menopausal women. If I could understand the mechanics of what happens when I sleep to cause the muscles to apparently go into spasm, I would have something to work with. I take Amitriptyline 25mgs which was brilliant at first! Thanks Judy!