One of the most common symptoms of multiple sclerosis (MS) is physical pain. For some people with MS, this pain affects the pelvic area. “I would be in so much pelvic pain, I would break down and cry. It was [preventing] me from doing anything,” one MyMSTeam member explained.

Another wrote, “When I sit and then get up to walk, the pain in my groin almost drops me!”

In MS, the body’s immune system targets parts of the central nervous system (CNS), part of the nervous system consisting of the brain, spinal cord and retina. This can lead to a wide variety of symptoms, including in the pelvic area. But pelvic pain can also be due to causes unrelated to MS.

Treatment for pelvic pain depends on its underlying cause, so it’s important to work with your healthcare provider to determine the reason for your pain.

Here’s what you need to know about MS and pelvic pain, including what can cause it, what it feels like, and how it can be managed.

What Does MS Groin Pain Feel Like?

Some MyMSTeam members have severe pelvic pain that impacts their daily life. Meanwhile, others have shared how their pain is fleeting: “I do get some groin and hip pain, more when I stand up from sitting,” one member shared, adding it that the pain doesn’t last long and that it seems to ease off after they make small movements.

Several members have shared how their groin pain is related to their menstrual cycle or other health conditions. “I have groin pain, especially during my period, and it often radiates to my hip and upper leg,” one member wrote.

Another said, “I have struggled with pelvic pain for many years due to a severe case of endometriosis. When I had my hysterectomy, I thought the pain would be gone forever, but that wasn’t the case. I still suffer from that same type of pain that led me to tears.”

Although some find that their groin pain is isolated, others experience it along with other symptoms. One member shared they experience pain that seems to emanate from their sacroiliac joint, which links the pelvis and lower spine.

People with MS can experience groin pain in many different ways. If you have pain that interferes with your daily activities, talk to your doctor. Your provider can help determine if your pain is due to MS and suggest a treatment to provide pain relief.

What Causes Pelvic or Groin Pain in MS?

Potential causes of pelvic pain in people diagnosed with MS include:

• Nerve damage
• Pelvic floor disorders (impairments the occur when muscles or connective tissues of the pelvic area weaken or become injured)
• Urinary tract infections (UTIs)
• Spasticity (muscle stiffness and tightness)

Nerve Damage

In MS, the immune system attacks the coating around nerves in the CNS called myelin. This process causes lesions (areas of damage) to form on the nerve cells and interferes with the messages they send to the brain. Neuropathic pain (nerve pain) occurs as the direct result of these lesions. It can feel like burning, sharp, stabbing pain throughout the body, including in the groin and the pelvis.

Nerve damage can also cause pain indirectly. When nerve damage affects your posture or how you walk, you may feel pain in your muscles, bones, ligaments, and tendons. This is caused by MS but isn’t experienced directly as nerve pain. One member who experienced this said, “I have bursitis in my hip caused by an altered gait due to MS.”

Pelvic Floor Disorders

It’s estimated that 68 percent of people with MS have at least one pelvic floor disorder. The most common symptoms of pelvic floor disorders include:

• Problems emptying the bladder or bowels — Reported in 41 percent of people with MS
• Overactive bladder — Reported in 69 percent of people with MS
• Sexual dysfunction — Reported in 42 percent of people with MS
• Loss of bowel control — Reported in 30 percent of people with MS

In people living with MS, spasticity of the pelvic floor muscles can also lead to pelvic pain. Other symptoms of pelvic floor disorders may include constipation, diarrhea, loss of bladder control, and pelvic organ prolapse.

Urinary Tract Infections

People with MS are at greater risk of UTIs. Problems with contracting (tightening) and relaxing the bladder muscles can lead to incomplete emptying during urination. This can result in infections.

UTIs can cause pain, pressure, and cramping in the pelvic area, lower abdomen, back, and sides. UTIs can also lead to serious complications. It’s important to be evaluated by a healthcare provider if you have new or worsening pelvic pain.

Spasticity

Many people with MS experience spasticity — a feeling of muscle stiffness or tightness. It can also lead to sudden muscle spasms, which are involuntary jerks or contractions. Like nerve pain, spasms occur when MS-related nerve damage disrupts the signals between the brain and muscles.

Spasticity can be painful and may affect different areas of the body, especially the legs, buttocks, and groin. In some people, it shows up in the lower back. When deeper muscles are involved, the discomfort may feel like groin or pelvic pain rather than being clearly located in the back.

Other Causes of Pelvic or Groin Pain

People with MS may also experience pelvic pain unrelated to their condition, such as from injuries. These can include labral tears, fractures (bone breaks), problems with the sacroiliac joint, and hernias.

Other conditions — including trapped nerves, joint and bone conditions, and irritable bowel syndrome — can cause or worsen pelvic pain. Other causes of pelvic pain include:

• Pelvic inflammatory disease (PID)
• Fibroids
• Ovarian cysts due to leftover tissue from removing one or both ovaries
• Interstitial cystitis (painful bladder syndrome)
• Mental health conditions

There are many conditions that can cause pelvic pain, so it’s important not to assume it’s related to MS. Work with your neurology provider to determine the cause of your pain and find the most effective treatment.

How To Manage Pelvic Pain With MS

The best treatment for your pelvic pain will depend on what’s causing it. Pelvic pain management may include:

• Physical and occupational therapy
• Medications
• Relaxation techniques

Work with your doctor to find a treatment option or intervention that will help improve your quality of life.

Physical and Occupational Therapy

Some pelvic pain related to MS can be treated by a physical therapist. Ask your healthcare provider for a referral to this kind of specialist.

Pelvic floor physical therapy can be key to relieving pain and other symptoms. Your physical therapist can help you learn how to control and strengthen the muscles you need to retain and eliminate waste effectively. One review noted that pelvic floor muscle training helped improve lower urinary tract symptoms, sexual dysfunction, quality of life, and mental health in people with MS.

Physical therapists can help treat spasticity by showing you how to stretch and realign the body. They can also give you exercises to help you resist spasticity. Aquatic therapy (exercising in the water) may be especially helpful for people with MS, as being in the water can make stretching and exercise easier and more effective.

One MyMSTeam member shared that they were recommended to physical therapy (PT) for spasticity that was causing groin pain: “Just saw my neurologist, and he said that it’s my hip flexor. He set me up for PT two times a week for 12 weeks. So yeah, spasticity or tight muscles.”

In addition to physical therapy, occupational therapy can help you manage groin pain. Occupational therapists can help you find ways to move or sleep that do not trigger your pain. They may also be able to help you find devices, like braces, that hold your body in place and reduce pain from spasticity.

Medications

Medications can help manage nerve pain, musculoskeletal pain, and spasticity related to MS. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and other over-the-counter pain relievers, may also provide relief from pain and inflammation due to injury.

The best medication for you depends on the specific cause of your pain and its severity. Medications that work for muscular pain may not work on nerve pain. Work with your healthcare professional to find the right medication for you.

Relaxation Techniques

Relaxation techniques may help with groin pain related to MS, especially if it’s caused by spasticity. Meditation, guided imagery, and deep breathing can help the body isolate the muscles that are spasming and help them relax. Over time, these techniques can help the whole body relax and can potentially alleviate pain, including groin and pelvic pain.

Find Your Team

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Do you deal with occasional or chronic pelvic pain? Share your experience in the comments below, or start a conversation by posting on your Activities page.