Deep pelvic or perineal ache
Worse with long sitting, cycling or after a long workday, and it feels deep rather than on the skin.
The ache is often deep in the pelvis or perineum and worse with sitting, cycling or a long workday. Pain can move between the groin, hips, tailbone, lower belly and genitals. Urgency or bowel discomfort can come along with it.
This condition usually involves several muscle groups rather than one injury: the pelvic floor, hips, inner thighs, abdominal wall and low back. Trigger points, tight knots in muscle that send pain elsewhere, are common. Over time the nervous system can become sensitized, so the area reacts faster and flares more easily.
I treat these muscles with dry needling, a form of acupuncture. The genitofemoral nerve runs through the iliopsoas, a deep hip flexor, and a tight iliopsoas can irritate it and send pain into the groin. Needling that muscle eases the pressure. The sacral segments, S2 to S4, serve the pelvic floor, so I also work at that level to help calm amplified pain. This runs alongside pelvic floor PT and your doctors.
Most people have had imaging, medication and sometimes general stretching or core strengthening. Trigger points and muscle guarding don’t show up on MRI or ultrasound. Medication can lower pain without changing how sensitive the muscles are. Stretching can aggravate a guarded pelvic floor, and core work can add tension when the hip muscles are already tight. PTs and chiropractors in New York can’t dry needle, so if you’ve had pelvic floor PT, needling is a new approach.
I start by asking where the pain goes, which positions set it off, and what you’ve already tried. Then the exam:
Pelvic floor PT, urology, gynecology, gastroenterology and primary care are all providers I work with. If anything on exam seems worth a closer medical look, I’ll mention it and share what I found.
Not necessarily. Those are medical diagnoses managed by your doctors. Muscle pain can exist alongside them or continue after they’re treated. I treat the muscle and nerve contributors and work alongside your doctors.
No. All of my pelvic floor treatment is done from outside the body, together with the hip and abdominal muscles around it. When internal work would help, I’ll refer you to a pelvic floor physical therapist.
I needle the tight muscles that recreate your pain. Loosening the iliopsoas, for instance, can calm the genitofemoral nerve that passes through it. Spinal work at the sacral level aims to quiet a sensitized system. Most people have some of each, so treatment usually blends them.
Imaging rules structural problems in or out, but it doesn’t show trigger points or guarding. I use pressure, symptom reproduction and movement testing to find which muscles and positions drive your pain.
Yes, temporary soreness or a short flare can happen, especially when the nervous system is sensitized. I start conservatively and pair treatment with guidance on positions and activity.
Seek urgent care for fever, chills, unexplained bleeding, being unable to urinate, or severe pain that keeps escalating. Numbness in the saddle area, worsening leg weakness, or any sign of infection also need prompt medical evaluation.
Adults with pelvic floor, nerve and orthopedic pain, along with neurological conditions. Most of my patients come to me after other care hasn't fully settled things. If you're looking for general wellness acupuncture, I'm not the right fit.
We review your history and what you've already tried. I assess the muscles and nerves involved, and you're treated the same day.
It depends on the condition. Pelvic and orthopedic plans usually run 4 to 6 weeks. Neurological plans are usually 2 visits a week for 6 weeks or 3 a week for 4. After that, visits space out so the changes hold. These are typical timelines, not promises.
Yes. I work alongside doctors, physical therapists and specialists. If something I find needs a closer look from one of them, I'll tell you.
I'm an out-of-network provider. You pay at the time of your visit, and my office submits the claim so any reimbursement comes to you. Free benefit checks are available before your first visit through the verification form, and HSA and FSA cards work. I don't take Medicare or Medicaid, though some Medicare Advantage plans reimburse out-of-network care. Full insurance details
Yes. I treat adults, teens and children, though I don't specialize in infants or toddlers.
Yes. Book a free discovery call to ask your questions and see whether we're a good fit.
Dry needling is a form of acupuncture. Fine needles go into tight bands of muscle and trigger points to lower muscle tension and change how the area is signaling.
You may feel a brief twitch or a deep ache as the needle reaches tight muscle. It passes quickly, and any soreness afterward usually fades within a day or two.
It's generally safe with a properly trained practitioner. Needles are sterile and single-use, and I check your health history first, including blood thinners. In New York, dry needling can only be performed by licensed acupuncturists, MDs and DOs. Physical therapists and chiropractors aren't permitted to perform it.
Eat something light beforehand and wear loose clothing that lets me reach the area being treated.
Usually not. Ultrasound helps in a few specific cases, but it hasn't been shown to improve results for common trigger points. A careful hands-on exam is what guides the needle. More on ultrasound-guided dry needling
Dry needling aimed at the pelvic floor and the hip and abdominal muscles around it, for pain, tension and urinary symptoms driven by those muscles and their nerves. More on pelvic floor dry needling
Sometimes, depending on the muscles involved, and you'll be draped throughout. Treatment always follows your consent and comfort. I don't do internal exams or internal treatment.
No, though it helps if you've already seen a doctor or pelvic floor physical therapist. Bring any notes or imaging you have.
Completely. I've heard it all, and there's no judgment here, just a straightforward conversation so we can treat what's going on.
Yes, I treat adults of every gender and identity. After gender-affirming surgery involving the pelvis, bring your surgical notes and we'll decide together what fits.
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Evidence-based acupuncture and dry needling on the Upper West Side. From chronic pain and headaches to pelvic floor dysfunction, Dr. Jordan Barber pairs the highest level of training with care that actually listens.
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