Pelvic Floor Condition
Chronic pelvic pain is pain in the lower abdomen, pelvis, or pelvic floor that persists for six months or longer. It is rarely caused by one thing — and that is exactly why so many patients have been told, repeatedly, that nothing is wrong.
What is actually happening is usually a combination: pelvic floor muscle dysfunction, bladder or bowel involvement, nerve sensitization, and sometimes gynecologic contributors. The path forward is multi-system evaluation — not one more test for one more cause.
It is important to be honest about scope: PHII treats the urogynecologic, anorectal, and pelvic floor components of chronic pelvic pain. When the picture involves significant gynecologic pathology like endometriosis, or non-pelvic pain syndromes, we coordinate openly with the appropriate specialists.
Most patients tell us they assumed the symptom was minor — or just something they would have to live with. Neither is usually true.
Treatment Approach
Most patients with chronic pelvic pain improve significantly with behavioral, physical, and minimally invasive treatments — long before surgery enters the conversation. Here is the full toolbox, in the order we typically work through it.
What to Expect
A comprehensive first evaluation with Dr. Johnson. Time to be listened to. In-office diagnostics when possible.
Dr. Johnson has read your intake before you walk in. The conversation starts with the impact on your life — not the textbook.
Performed with explanation at every step. Nothing happens without your full awareness and consent.
Diagnostics are performed in-office where possible to avoid extra appointments.
Every option explained. Pros, cons, and what each one would mean for your week, your work, and your life.
A Patient Story
I had been told by four physicians over six years that it was “just stress.” The exam at PHII took 45 minutes and identified actual pelvic floor trigger points. PT, an injection, and a coordinated plan with a pain physician — and I have my life back.
— S.D., treated for chronic pelvic pain with pelvic floor dysfunction
Frequently Asked
No. If a careful evaluation finds nothing identifiable, I will say that — and I will also tell you what we should look at next and who else might be helpful. But in my experience, when a patient is told nothing is wrong by a generalist, what they usually mean is that nothing was found within their scope. A subspecialist's scope is different.
— Lisa L. Johnson, M.D., U.R.P.S.
No. It is in your nervous system, your pelvic floor, your bladder, and sometimes in conditions adjacent to those. The brain participates — all pain does. But the contributors are real and identifiable, and treatment is targeted at the actual drivers.
— Lisa L. Johnson, M.D., U.R.P.S.
Usually no. Chronic pelvic pain is overwhelmingly a non-surgical condition, and surgery rarely improves it when the diagnosis is pelvic floor dysfunction or sensitization. Surgery has a role when there is an identifiable structural driver — but the bar is high, and the conversation is careful.
— Lisa L. Johnson, M.D., U.R.P.S.
Honest answer: longer than patients want, and shorter than they fear. Most patients see meaningful improvement within three to six months of starting a coordinated plan, with continued progress over the following year. I will not promise a quick fix, and I will not let you stay on a plan that isn't working.
— Lisa L. Johnson, M.D., U.R.P.S.
I evaluate and treat the pelvic floor and urogynecologic components that very often coexist with endometriosis. The endometriosis itself, when complex, is best handled by a gynecologic surgeon who specializes in it. We coordinate care directly, share notes, and avoid sending you between offices unnecessarily.
— Lisa L. Johnson, M.D., U.R.P.S.
A thorough, unhurried evaluation with Dr. Johnson. You will leave with a written plan — and clarity on what chronic pelvic pain is doing in your body, and what to do about it.
