Pressure like a ball when sitting
Worse on firm chairs and in cars. Eases standing or lying down, then returns when you sit again.
People describe a ball, a lump or a fullness at the perineum, the tailbone, or deep in the rectum or vagina. It’s worse when sitting and often eases when standing or lying down. It’s a symptom with more than one possible source, so medical causes should be checked.
When the source is muscular, the pelvic floor is commonly holding protective tension, especially the levator ani. Sitting then presses on tissue that is already sensitive. Signals from the pudendal and sacral nerves can be amplified, so ordinary pressure feels like a foreign object even when there isn’t one.
For this I use dry needling, a form of acupuncture, along with electroacupuncture. The levator ani and obturator internus can crowd the pudendal nerve right under where you sit. Needling those muscles helps give it room. Sometimes the perineal branch of the pudendal nerve stays irritable after the muscle eases. In that case I use electroacupuncture, fine needles near the nerve with a gentle current, to help shift its signaling.
Most people have had imaging or exams, then medication trials, stretching or general strengthening. When tests come back normal, reassurance is often all that’s offered. Imaging doesn’t show trigger points, guarding or nerve sensitivity. Strengthening may not help when the muscles are already too tight. Pelvic floor PT is often tried first. Dry needling isn’t part of it in New York, where PTs and chiropractors aren’t allowed to needle.
I start by asking how long you can sit before it starts, exactly where you feel the ball, and which positions change it. Then the exam:
I work alongside gastroenterology, urology, gynecology and pelvic floor PT. If my exam suggests one of them should take a look, I’ll let you know and send my findings.
Not necessarily. Tight pelvic floor muscle, trigger points or nerve sensitivity can create this feeling without any mass. Because medical causes are possible, it’s worth seeing a physician for an exam. That matters most if the feeling is new or getting worse.
Seek urgent care for rectal or vaginal bleeding, fever, or sudden severe pelvic or belly pain. New trouble emptying your bladder also needs prompt attention. So do sudden bowel changes, such as new leakage or being unable to pass stool or gas, or symptoms that are worsening quickly.
If the main issue is tight muscle with trigger points, flexibility may not be the limiting factor. Most people need a combination, because muscle and nerve sources tend to overlap here. Releasing the levator ani takes weight off the nerve beneath it. A nerve that stays reactive gets the low current treatment as well.
It depends on how long you’ve had it, how sensitive it is, and how limited your sitting is. Most people start with a short block of visits, then space them out. I adjust based on sitting time, how quickly flares settle, and exam findings.
No. I don’t do internal pelvic floor work. I reach the pelvic floor externally, along with the hip rotators, sacral area and belly wall. A pelvic floor physical therapist is who I’d refer you to if internal work would help.
They can, especially when the pelvic floor is already tight or seat pressure is a main trigger. The goal isn’t to avoid everything. I help you find which part provokes it, such as seat pressure, breath holding, intensity or duration, and build back gradually.
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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