Visceral Manipulation for Pelvic Pain and Constipation Relief

Written By Katharine Seim

The Boston Pelvic PT team is now trained in Visceral Manipulation, a gentle, hands-on technique that supports healing in the abdomen and pelvis. This approach can help with ongoing pelvic pain, tightness after C-section or other abdominal surgeries, and digestive issues like constipation or bloating, especially when other treatments haven’t made a big difference. We work with patients throughout the Boston area who are looking for a low-risk, non-invasive way to feel and move better again.

What Is Visceral Manipulation? (Gentle Abdominal Therapy Explained)

Visceral Manipulation (VM) uses light, precise touch to help your internal organs and surrounding tissues move more freely. While traditional physical therapy often focuses on muscles and joints, VM looks at the mobility of your organs, like your stomach, intestines, and bladder, and how they may affect your pain or function.

This approach was developed by French osteopath Jean-Pierre Barral. It’s based on the idea that your organs should glide and move with you as you breathe, stretch, digest food, and go about daily life. When the connective tissue around an organ (called fascia - include graphic) becomes tight, from surgery, inflammation, injury, or even long-term stress, it can restrict movement and cause pain or pressure in the abdomen, pelvis, back, or hips.

Why Organ Mobility Matters for Pelvic Pain and Digestive Issues 

Your organs aren’t still inside your body - they move with every breath, step, and stretch you take. For example, the liver can shift up to about 2 inches during deep breathing as the diaphragm moves. That movement helps with normal digestion, circulation, and pressure balance in your core.

But after abdominal or pelvic surgery (such as a C-section, hysterectomy, or endometriosis surgery), scar tissue (adhesions) can form. These stiff areas can act like glue, sticking tissues together that are meant to glide smoothly.

When that happens, it can lead to:

  • Pain in the pelvis, lower back, or hips by pulling on nerves and muscles

  • Digestive issues like constipation, bloating, or discomfort after eating

  • Pelvic floor tension, making sex, bowel movements, or medical exams painful

  • Core weakness or altered breathing, especially postpartum

  • Urinary urgency or pressure, when restricted tissues affect the bladder

VM helps reduce tension and restore movement so your body can work more comfortably again.

Does Visceral Manipulation Work? Here’s What the Research Says

  • A 2023 meta-analysis called “Analysis of the efficacy of abdominal massage on functional constipation” looked at 13 studies with 830 people who had functional constipation. It found that abdominal massage helped people have bowel movements more often and with less difficulty, reduced abdominal discomfort, and improved quality of life. This suggests abdominal massage may be a safe, low-risk option for managing constipation, but larger and higher-quality studies are still needed to confirm how well it works [1].

  • A 2023 study on 79 people with chronic low back pain found that adding Osteopathic Visceral Manipulation (OVM) to regular physical therapy led to better pain relief, improved function, and reduced depression symptoms compared to physical therapy alone. These results suggest OVM can be a helpful addition to treatment for long-term back pain, though larger studies are still needed to understand its long-term effects [2].

  • A 2025 pilot study on 29 adults with functional dyspepsia (ongoing upper-abdominal pain without a clear medical cause) found that 10 sessions of visceral manipulation over 2 weeks led to less abdominal pain and better daily function, with no serious side effects reported. Because the study was small and did not include a comparison group, more research is needed, but the early results suggest VM may be a low-risk option for improving digestive-related symptoms [3].

  • In a 2025 study published in the Journal of Clinical Medicine, 60 women who had recently had surgery for endometriosis or pelvic organ prolapse received five weekly sessions of visceral manipulation. They showed significant improvements in quality of life, and no side effects were reported, suggesting VM is a low-risk, non-invasive option after pelvic surgery. Because this was a small study, more research is needed, but the results indicate VM may be a helpful addition to postoperative recovery [4].

How We Use Visceral Manipulation in Pelvic Floor Physical Therapy

At Boston Pelvic Physical Therapy, we use Visceral Manipulation as one part of a comprehensive, whole-body treatment plan. VM is often combined with pelvic floor muscle training; soft tissue and myofascial release; breathing and core coordination; movement pattern and posture retraining; and stress and pressure-management strategies. This approach allows us to treat the root of your pelvic or abdominal symptoms, not just the surface.

VM may be a helpful addition to your treatment plan if you are experiencing:

  • Post-surgical pain or tightness: After a C-section, hysterectomy, abdominal surgery, or endometriosis surgery, VM can help improve tissue mobility and reduce scar-related restrictions.

  • Digestive problems: Including constipation, bloating, or IBS-type symptoms, especially if diet changes alone haven’t helped.

  • Pelvic pain: Such as pain with sex (dyspareunia) or tension in the muscles and tissues around the pelvis.

  • Postpartum issues: Including core weakness or diastasis recti, and ongoing discomfort after pregnancy and birth.

  • Unexplained low back or hip pain: When deeper fascial or organ tension may be contributing to symptoms.

What to Expect During Visceral Manipulation Treatment

VM sessions are gentle and typically comfortable. Your therapist applies light, precise pressure to your abdomen, either on the skin or through clothing. You may feel warmth, a light stretch, or even hear your stomach gurgle - all normal signs that tissues are relaxing and movement is improving.

Many people notice easier breathing or less abdominal tension right after treatment. Most see progress within 3–6 sessions, though this can vary.

At your first visit, we’ll create a personalized plan and adjust it as you improve. We’ll also teach you simple abdominal self-massage techniques to support your digestive and pelvic health at home.

Want to Learn More About Visceral Manipulation?

If you’re dealing with pelvic pain, constipation, lingering discomfort after surgery, or postpartum core weakness, Visceral Manipulation may help you feel and move better. The Boston Pelvic Physical Therapy team is here to help! Schedule your visit today:

Research References:

[1] (Gu, X., Zhang, L., Yuan, H., & Zhang, M. (2023). Analysis of the efficacy of abdominal massage on functional constipation: A meta-analysis. Heliyon, 9(7), e18098. https://doi.org/10.1016/j.heliyon.2023.e18098, Pub Med: https://pmc.ncbi.nlm.nih.gov/articles/PMC10366436/)

[2] Altınbilek, T., Murat, S., Yıldırım, E., Filiz, B., Ünlü, S., & Terzi, R. (2023). Evaluation of effectiveness of osteopathic visceral manipulation in patients with chronic mechanical low back pain: A multi-center, single-blind, randomized-controlled study. Turkish Journal of Physical Medicine and Rehabilitation, 69(4), 500–509. https://doi.org/10.5606/tftrd.2023.12541

[3] Arisandy, A., et al. (2025). Visceral Manipulation as Non-Pharmacological Management in Adults with Functional Dyspepsia: A Pre-Post Pilot Study in Primary Care. Asian Journal of Medical Health Sciences, 8(1), 58–65.

[4] (Wójcik M, Kampioni M, Hudáková Z, Siatkowski I, Kędzia W, Jarząbek-Bielecka G. The Effect of Osteopathic Visceral Manipulation on Quality of Life and Postural Stability in Women with Endometriosis and Women with Pelvic Organ Prolapse: A Non-Controlled Before–After Clinical Study. J Clin Med. 2025;14(3):767. doi:10.3390/jcm14030767)

Katharine Seim
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