01/15/2026
One of the most frustrating experiences for women with pelvic pain or endometriosis is being told that tests look normal.
Here are six real reasons pelvic pain often doesn’t show up clearly on imaging:
Muscle guarding and overactivity
Tight or constantly braced pelvic floor muscles don’t appear on scans, but they can drive significant pain.
Nervous system sensitization
When pain has been present for a long time, the nervous system can amplify signals even without visible tissue damage.
Scar tissue and adhesions
Scars don’t always show clearly on imaging, especially when they affect movement and glide between tissues.
Inflammation patterns that fluctuate
Pain related to hormonal cycles or inflammation can change day to day and may not be present at the time of imaging.
Altered tissue mobility
Restricted movement between layers of tissue can create pain with pressure, movement, or pe*******on without structural abnormalities.
Pressure and load sensitivity
Pelvic pain often relates to how the body handles pressure during sitting, standing, s3x, bowel movements, or exercise — something scans don’t measure.
Pain doesn’t need visible proof to be real. It needs context, pattern recognition, and a whole-body understanding of how tissues and the nervous system are responding.
If you’re in the Encinitas or San Diego area and living with pelvic or endometriosis-related pain that hasn’t been fully explained, comment HEAL.