Table 1.

Referred Pain Patterns: Pelvic Floor Muscles

Pelvic Floor Muscle	Referral Pattern	Possible Patient Complaint
Superficial Muscle Layer
Bulbocavernosus	Perineal pain, urogenital structures	Dyspareunia, pain with orgasm, clitoral pain
Ischiocavernosus	Perineal pain, urogenital structures	Dyspareunia, pain with orgasm, clitoral pain
Transverses perineum (Superficial transverse perineal)	None documented	Dyspareunia
Anal sphincter (Sphincter ani externus)	Posterior pelvic floor, anus/rectum, pubic pain	Burning or tingling in anus/rectum, pain before/during/ after defecation
Deep Muscle Layer
Levator ani anterior: Pubococcygeus/puborectalis	Suprapubic region, urethra, bladder, perineum, pain/symptoms	Increased urinary urgency & frequency, Painful urination after intercourse, dyspareunia
Levator ani posterior: Iliococcygeus	Sacrococcygeal, deep vaginal, rectal, perineal, anal pain	Pain before/ during/after defecation, dyspareunia, thrusting pain
Other Deep Pelvic Floor Muscles
Coccygeous	Sacrococcygeal, buttock pain	Pain with sitting, during defecation, intestinal fullness, anal pressure/pain
Obturator internus	Anal, coccyx, vulvar, urethral, vaginal, or posterior thigh pain	Generalized pelvic pain, often burning or aching
Piriformis	Sacroiliac region, lateral over ipsilateral buttock, posterior over	Buttock, leg pain if sciatic nerve affected
	ipsilateral hip, proximal 2/3 of posterior thigh

Note. For more information about referred pain patterns in the pelvic floor muscles see Itza et al., 2010; Simons et al., 1999a; Simons et al., 1999b; Wise & Anderson, 2010.