There can be many different causes of chronic pelvic pain in men and women. Most causes of pelvic pain varies greatly from each individual. The symptoms that are typical with pain in the pelvis (pelvic floor myalgia), are pain in the lower back, groin pain, muscle tightness in the rectum (including rectal spasms), etc. Sometimes referred to as "pelvic floor tension myalgia", causes of chronic pelvic pain can be hard to pinpoint. Each person is different. In most cases, pelvic pain symptoms occur after surgery or inflammation/infection near the pelvic floor muscles.

The root cause of most types of chronic pelvic pain is tension in the pelvic floor muscles. This tension can cause a variety of different types of pelvic pain: levator ani syndrome, interstitial cystitis, chronic prostatitis, vulvar vestibulitis, and dyspareunia. There is new evidence showing that in order to reduce the causes of chronic pelvic pain, chronic tension in the pelvic floor muscles must be reduced to stop painful symptoms. Incorporating daily relaxation and having physical therapy on the internal muscles (such as the levator ani) can have a huge impact on pain levels.