The pelvic floor muscles close the bottom of the pelvis. The rectum, vagina and urethra travel through the pelvic floor muscles. If a patient has chronic pain in the lower abdomen, the pelvic floor muscles may become spasmic and sore. The typical symptoms of this include painful intercourse, painful bowel movements as well as difficulty emptying the bladder as well as a general feeling of pressure and heaviness low in the pelvis. The main treatment for this is pelvic floor physical therapy. The focus of this is to allow the pelvic floor muscles to relax better. However, sometimes pelvic floor physical therapy is not enough and then botox injections into the pelvic floor may help to further relax the pelvic floor muscles. While botox only lasts for about 6 months, this is sometimes enough to break the cycle of pain and tension and the physical therapist can more aggressively treat the pelvic floor dysfunction after the botox injection. Some patients will require repeated treatments however.