Managing Pelvic Pain
Because there are many potential causes of chronic pelvic pain, booking an appointment with Pain Specialist, or (if you are a woman), a Vulva Doctor, is the smart way to go. The good news is that there are now a number of successful conventional & cutting-edge treatments that can get you back on track. – But the first step is to get an accurate diagnosis – something that a general practitioner may not be able to do, due to their lack of extensive training & experience in the complex field of pain and pain medicine
The Basics
Chronic pelvic pain is an umbrella term that captures a wide range of diagnoses that cause persistent pain in the pelvis and last greater than three to six months. It affects both men & women with an estimated prevalence as high as 40%” [1]
When you have an initial online or in-person consultation with a Pain Specialist or Vulva Doctor, they will review your medical history, and then (if necessary), arrange for you to have a physical examination, and any important tests & scans, which will help to pinpoint the cause of your pelvic pain. They will then devise a holistic Personalised Treatment Plan which could comprise a combination of different modalities that are designed to improve your quality of life right from the get-go. All follow-up appointments can be scheduled to fit in with your work and family commitments, and when an in-person appointment is not necessary, then this can be done online.
So What Types of Treatment Are on Offer?
Key treatments include:
•Specific pharmaceuticals which can help to relieve pain
•In the case of women: hormonal treatments (i.e., birth control pills or other hormone medications) are prescribed for patients who find that: their pelvic pain coincides with a specific phase during their menstrual cycle, and the hormonal changes which manipulate menstruation and ovulation
•Antidepressants that have a good success rate
•Antibiotics
•Physical therapy (provided by another medically qualified team member)
•TENS treatment
•Biofeedback
•Neurostimulation
•Trigger point injections [2].
Putting a Spotlight on Neurostimulation & Trigger Point Injections
Neurostimulation
“There are a number of reports of successful use of neuromodulation to treat chronic pelvic pain. Both traditional spinal cord stimulation & peripheral/sacral nerve stimulation were shown to be useful for treating CPP” [1]
Also known as spinal cord stimulation; neurostimulation is a popular procedure which involves a Pain Doctor or Vulva Specialist implanting a special device in the patient. This is designed to block specific nerve pathways, so that the pain signals they transmit, cannot reach the patient’s brain. Note: neuromodulation incorporates various types of neurostimulation, however, it can also take place using medication, thereby delivering a pain relief or anti-spastic agent directly into a target site via a catheter and pump, thus minimising the required dose, and potential side effects [1].
Trigger Point Injections
If your Pain Specialist or Vulva Doctor discovers particular points where you are experiencing pain, then they may suggest that you have a numbing medicine injected into these precise areas (trigger points). Generally speaking, the medication which is used, is a long-acting local anaesthetic, which can successfully ease discomfort and block the patient’s pain [2].
References
[1]. International neuromodulation Society (2021). “Chronic Pelvic Pain.”
https://www.neuromodulation.com/CPP
[2]. Mayo Clinic (2021). “Chronic Pelvic Pain in Women.”
HYPERLINK “https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/diagnosis-