Chronic Burning Pain Down There? What You Should Know About Vulvodynia

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woman with pelvic model

What is Vulvodynia?

If you or a friend have experienced pain in the external vaginal area lasting three or more months with no known cause, you may find relief in understanding Vulvodynia. Vulvodynia refers to chronic pain and discomfort of the vulva, which is the external part of the female genitalia including the labia, the clitoris, the vaginal opening, and the urethral opening. Pain associated with Vulvodynia can be generalized over the entire vulvar region or localized to a specific area. As a note if painful sensations are limited to the entrance of your vagina, that condition is called vestibulodynia. 

Pain linked to Vulvodynia can be constant, or it can occur intermittently. This pain can be especially noticeable when the affected area is touched. Many report increased discomfort during or after intercourse, when wiping after urination, or with certain activities such as biking and prolonged sitting. The pain is often described anywhere along a continuum from very mild to severe, and it is typically described as a stinging, burning, itching, swelling, or a raw sensation.

What Causes Vulvodynia?

While the cause of vulvodynia is unknown, researchers believe it may be the result of a combination of factors. Some of these factors include: 

  • Irritation and injury to the nerves of the vulva
  • Hormonal changes
  • Genetic inclination, allergies, or skin sensitivities
  • Muscle spasm or dysfunctions of the pelvic floor
  • Long term reaction to infections or increased inflammation

How Pelvic Physical Therapy Can Help Relieve Vulvodynia Pain

Treatment for vulvodynia typically includes a multi-disciplinary approach. The good news is that physical therapy often can play a major role in relieving pain. Your therapist will perform a thorough evaluation and create a plan of care that is tailored to your individual needs. Your pelvic floor physical therapist may consider the following treatment modalities:

Manual Therapy

Also know as manipulative therapy, this treatment modality is aimed at addressing the mobility of your muscles, joints, and connective tissues.

Pelvic Floor Muscle Coordination

You may also work on proper coordination of your pelvic floor to ensure that you are able to contract and relax your muscles at the appropriate times. 

Hygiene Best Practices

A physical therapist may also guide you on good genital hygiene practices to keep you happy and healthy down stairs.

Modified Motion

You may discuss ways to modify activities to promote reduced pain and improve pelvic floor functionality.

Behavioral Strategies

A physical therapist can also help advise on behavioral strategies to help make pain management easier for everyday activities (including sex).


Strategies can be employed to decrease tissue sensitivity and help relax your pelvic floor muscles. 

Stretch and Relax

A physical therapist will likely prescribe exercises which may include stretching and relaxation activities, nerve gliding, or strengthening exercises based on what is appropriate for your presentation.

While the diagnosis of vulvodynia may seem overwhelming or scary, working with a physical therapist can help reduce your fears, understand your symptoms, and improve your quality of life.


If you have pain in your parts, Download this free guide to find out if pelvic floor tightness might be to blame—and what to do about it.

– By Ashley Holstein PT, DPT 

Some links may be affiliate links. The products we recommend are products we use or recommend to clients.


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Meet Dr. Sara

Sara Reardon PT, DPT, WCS is the owner of NOLA Pelvic Health and founder of The Vagina Whisperer.

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