Introduction
Any pelvic pain that lasts six months or longer is categorized as chronic pelvic pain. Often, even after the original cause of the pain is treated, the pain persists. This is known as chronic pelvic pain (CPP) syndrome. You're probably thinking, "Why does this happen, and how can I get relief?" Keep reading to find out.
The Mechanism Behind Chronic Pain
- Pain signals are handled differently in the brain of people with chronic pain.
- There is increased nerve sensitivity and an upregulation of nerve signals transmitted to the brain. Stress and anxiety can add further to this dysfunction.
- Pain signals travel to the brain through specific pathways via the spinal cord. Parts of the spinal cord act like a gate that can block or weaken these signals.
- In people with chronic pain, this gate in the spinal cord may malfunction, remaining open longer, even after the injured tissue has healed. This is when pain is experienced despite the original cause already being treated.
A doctor will diagnose chronic pelvic pain following a thorough physical exam and any lab tests or scans deemed appropriate in their medical opinion.
How Can CPP Be Treated?
Chronic pain affects every aspect of physical and emotional life. Because pain involves both the body and the mind, effective treatment addresses both. A multidisciplinary team can include a doctor, a physical therapist, a counselor, and cognitive behavioral therapy or psychotherapy.
- Pain medications: Early treatment can start with medications that make symptoms more bearable, sometimes combining medications to interrupt excessive pain signaling.
- Physical therapy: CPP can cause tension in the muscles of the pelvis, leading to bladder, bowel, and sexual dysfunction. This tension can create trigger points that are addressed through physical therapy and relaxation techniques.
- Psychotherapy: Psychological symptoms seen with CPP, such as anxiety, depression, and behavioral changes that strain relationships, can be addressed through counseling or psychotherapy.
How Soon Can You Expect Pain Relief?
Chronic pain took a long time to develop, resulting in physiological changes that have to be reversed to help decrease the pain. So here's what I want you to hear: please be patient. Patience is a big part of your healing journey.
Follow the instructions given by each member of your team. It may take three to six weeks or more to start seeing results. I know that sounds like a long time, but remember, it took a long time to develop, and relearning has to take place.
Conclusion
- CPP is one of the most common and disabling medical issues, affecting about 25% of women.
- CPP can be due to an improperly functioning pain gate pathway in the spinal cord.
- A multidisciplinary team approach is best for addressing symptoms that are psychosomatic in nature.
- Treatment requires patience and doing your part alongside your multidisciplinary team.
Chronic pelvic pain often affects bladder, bowel, and sexual function as well. Learn more about our approach to pelvic pain treatment and bladder and bowel dysfunction, or request an appointment to talk with Dr. Kavitha directly.