The nervous system and chronic pelvic pain: Why regulation matters
If you live with chronic pelvic pain your nervous system could be stuck in a constant state of “protect and brace.”
One of the most common signs? A tight, overactive pelvic floor. Even if you're not consciously squeezing those muscles, your body may be holding tension there without you even realising it.
In this article, we’ll explain the nervous system–pelvic pain connection, how to recognise signs of dysregulation, and how Women’s Health Physiotherapists can help.
Understanding the nervous system–pelvic floor connection
Your autonomic nervous system (ANS) controls all of the things your body does automatically (e.g. heartbeat, digestion and breathing). It has two main branches:
🟥 Sympathetic Nervous System: Your “fight or flight” mode helps you respond to danger or stress.
🟩 Parasympathetic Nervous System: Your “rest and digest” mode supports relaxation, healing and recovery.
In a regulated system, your body moves fluidly between these states depending on what’s needed. But when someone has lived with chronic stress, pain or trauma, the system can get stuck in a heightened survival mode (fight, flight, freeze or fawn).
When this happens:
Pelvic floor muscles may remain overly tight or guarded
Pain signals in the brain can become amplified
Digestion and hormones may be affected
The body struggles to switch off and rest
What is nervous system dysregulation?
Nervous system dysregulation occurs when the body doesn’t return to baseline after stress. Instead, it stays in a state of high alert, leading to persistent physical symptoms.
Common signs of a dysregulated nervous system:
• Chronic pelvic tension or pain
• Feeling easily overwhelmed or emotionally drained
• Difficulty sleeping or staying asleep
• Persistent tightness in the neck, jaw, or pelvic floor
• Constipation, bloating, or other gut symptoms
• Irregular cycles, PMS, or hormonal imbalances
• Pain flare-ups after emotional stress
Why this matters for pelvic pain
Your pelvic floor muscles are directly influenced by your stress levels. When the nervous system is on edge, the pelvic floor tends to hold tension.
This can worsen or lead to symptoms such as:
• Pain during or after sex
• Bladder urgency or frequency
• Constipation or difficulty emptying
• A sense of heaviness or burning
• Ongoing discomfort without a clear cause
How Women’s Health Physiotherapy can help regulate your nervous system
Women’s Health Physiotherapists are trained to support those with chronic pelvic pain. Here’s how they do it:
1. Creating a sense of safety
Before any treatment can truly help, your body needs to feel safe. Trauma-informed physios move slowly, explain everything clearly and ensure you feel in control to help shift the body out of survival mode.
2. Breathwork and pelvic floor downtraining
Targeted breathing techniques help activate the parasympathetic system, supporting muscle release and reducing tension. Physios may teach:
Diaphragmatic breathing
Mind-body awareness
Gentle pelvic floor relaxation strategies
3. Hands-on techniques
Rather than using deep or painful manual therapy,Women’s Health Physios often use gentle, targeted touch that works with your body. This approach sends calming signals to your nervous system, reduces protective guarding in the tissues, and helps your body begin to feel safe enough to let go of held tension.
4. Education and empowerment
Understanding the why behind your symptoms can be a game-changer. Physios help you connect the dots between your history, your symptoms, and your nervous system to help you feel more in control.
5. Movement that reduces bracing and builds safety
When the nervous system is on high alert, the body often responds by bracing. Over time, this protective tension can become automatic, making even gentle movement feel threatening or painful.
A Women’s Health Physiotherapist can help you explore safe, supportive ways to move that gently reduce this bracing response. Through calming, low-load movement and body awareness techniques, you can begin to:
• Release unconscious holding patterns
• Reconnect with areas of the body you may have "shut off" from
• Feel safe and confident moving again
We’re here to help
If chronic pelvic pain is affecting your daily life, our Women’s Health Physiotherapists can help. With a gentle, evidence-based approach that supports both your body and nervous system, we’ll work with you to reduce pain, restore balance and help you feel more at ease in your body again.
Book An Appointment
Book an appointment with one of our Women’s Health Physiotherapists today.
To make a booking, phone 07 5337 9853.
