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PERSISTENT PELVIC PAIN
Persistent pelvic pain can be described as pain perceived in structures related to the pelvis, low back, stomach, buttock and pelvic floor region. It is often associated with negative cognitive, behavioural, sexual and emotional consequences as well as with symptoms suggestive of lower urinary tract, sexual, bowel, pelvic floor or gynaecological dysfunction. It is considered chronic if it has lasted for six months or longer. Pelvic pain affects up to 26% of woman and 15% of men worldwide. This is as common as asthma and low back pain, but we hardly ever hear about it.
Pain is important, if our brain didn’t produce pain, we’d probably be dead - it’s one of our survival mechanisms. You only stick your hand in the fire or drop a heavy object on your foot once to realize you won’t do that again (well let’s hope so). But when pain persists beyond normal healing (12 weeks), that’s when pain isn’t so great. You start to notice the more you do the more it hurts? Pain becomes unpredictable and unreliable and you become more fearful as time goes on. Pain becomes like an over sensitive car alarm - you only walk past the car and the alarm goes off, not helpful.
TYPES OF PELVIC PAIN
There are many conditions that fall under the umbrella term persistent pelvic pain. Common diagnoses are dyspareunia, coccyx pain, bladder pain syndrome, endometriosis, vulvodynia, pudendal neuralgia, pelvic girdle pain, pubic symphysis, sacroiliitis or pelvic floor muscles pain syndrome. In many cases, regardless of the diagnosis there is often an emotional cause too. People commonly report low mood, thoughts, poor sleep, relationship / work commitment issues. Even with a detailed history it is sometime hard to know what came first, it can be a case of ‘the chicken or the egg’, therefore a team approach is often needed.
Pelvic pain conditions can be very distressing - but there is help. It’s hard for people in persistent pain to know who to see? The right treatment depends on the cause or causes of your pain. Your G.P will check for medical issues and refer you on as required. A psychologist is extremely beneficial to help with low mood, thoughts or beliefs - this can have a huge effect on reducing pain. Connecting with a pelvic health physiotherapist can be invaluable to help you understand your contributing factors, plan with you the best approach and give you the tools to help manage or resolve your symptoms.
Think of them as the co-pilot on the journey.