Persistent (Chronic) Pelvic Pain
Chronic, or persistent pain, is very complex and has a variety of contributing factors. Often, patients with pelvic pain see many doctors before someone gives them a diagnosis, and once given, the treatment options are often disappointing for the person experiencing symptoms. Sometimes, after going through a medical work up and imaging studies, the patient is told that there is nothing medically wrong, despite their ongoing symptoms. This can be distressing and frustrating for the patient, because though there is nothing medically wrong, the symptoms are undeniable.
There are many misunderstandings with regards to chronic pain, in general. The pelvis is an especially difficult area, as there are also many misconceptions about pain in the pelvis and the genitals. Much of the research in this area is new - and many medical professionals are not familiar with the most recent scientific and clinical advances. There are many barriers to accessing treatment for chronic pelvic pain, including sexual health issues, cultural expectations, financial issues, privacy, and religious issues.
So, what are the factors that impact pelvic pain that can be addressed by a physiotherapist? Some of the most common factors are: altered pain processing in the central nervous system, increased pelvic floor muscle tone and tension, altered lumbopelvic and hip muscle control, irritated nerves in the pelvic region, and posture, among other factors.
Many of the pelvic pain syndromes doctors and patients have struggled with for years derive (at least in part) from myofascial disorders. For example, women are often diagnosed with irritable bowel syndrome or interstitial cystitis when in fact their pain may be myofascial in origin.
With careful, detailed assessment and treatment planning - many of these problems can be addressed. In some cases the problem can be completely resolved or at least managed much more successfully. Treatment for chronic conditions is rarely a "quick fix" - usually it takes time to unravel the problem and address all of the issues that may be contributing to the problem in consultation with your medical team. Our therapists treat clients with persistent pelvic pain disorders using a multifaceted approach.