Pelvic pain is a complex condition. To successfully treat it you will need a formal diagnosis from a doctor, followed by an interdisciplinary approach to treat the original cause of the pain (if known), alongside the symptoms. Counselling will be offered to ensure you are adequately supported throughout your treatment as the emotional impact of suffering can be more substantial than the pain itself. This holistic approach is essential to resolve the full impact suffering from pelvic pain has had on your life.
In 61% of pelvic pain cases, the original cause of the pain is never known and impossible to identify. In these situations the treatment plan will include dietary and psychosocial (social, environmental and physcological) treatments which look to resolve the symptoms, before turning to medication. The general principles of treating chronic pelvic pain are often added to if further diagnosis becomes available during the programme of treatment.
You may be referred to one or more specialists depending on the location and cause of the pain, and how you respond to certain treatments.
It may take time before your pain to be fully resolved, but it should lessen within the first few weeks. The goal will be to make the pain manageable as soon as possible, to improve your attitude and allow you to return to work and your normal activities. Most treatments can be continued at home, once discussed with a GP or Physiotherapist.
Conservative Treatment Options
Conservative therapy's include all medical and non-medical treatment approaches which do not involve surgery. They often relate to your diet, environment, relationships and personal well-being. For more information on the leading treatments for pelvic pain, select the links below.
- Muscle relaxation and pain relief - If you are stressed or tense, just like any other muscle, the pelvic floor will get tense. Techniques to relax the body include breathing, warm baths and gentle massages. Working with a Physiotherapist you can relieve tension in the pelvis through muscle strengthening and flexibility exercises.
- Sacral nerve stimulation - The sacral nerve is responsible for the control you have over your pelvic floor muscles. It is a group of 31 nerves that begin at your lower back and reach to the pelvis. They can be strengthened through neuromuscular electrical stimulation (NMES). Ideal when you are unable to voluntarily strengthen these muscles or need a much quicker solution that manual Kegel exercises can provide.
- Tibial nerve stimulation
- Medication - Antidepressants can help you manage your emotions as you undergo treatment. Alongside various pain relief medications, topical anaesthetic creams, and Botox injections to reduce sensitivity and tightness. Antibiotics can be appropriate for when an infection is present.
- Strengthen your pelvic floor with Kegel exercises - Having a strong pelvic floor is essential to having control over your pelvic organs.
- Wear loose cotton clothing and avoid sitting for long periods - Some forms of pelvic pain are worse when there is pressure on the perineum and vagina.
- Avoid potential irritants and soothe the area - Keep clean and avoid heavily scented products. Wash with cool water after going to the bathroom.
- Modify your sex and exercise - Changing your exercise routine and avoiding penetrative sex can relieve pain.
- Relieve stress - Stress often enhances the sensation of pain and affects your ability to cope with it.
- Try an elimination diet - Supported by a Nutritionist, an elimination diet can determine whether certain foods affect your condition. It can also improve your bladder and bowel regimes.
- Cognitive behaviour therapy (CBT) - This therapy aims to change the way you think about your condition, helping you to look at the positive aspects of your life more often so you are more resilient against your pain.
Surgical Treatment Options
Surgery is usually reserved for patients with debilitating pain or in emergency life threatening situations. Unfortunately pelvic pain can be mistaken for a physical problem when it is not always, leading to unnecessary pelvic surgery that does not resolve the issue.
Undergoing a pelvic surgery increases your risk of developing other pelvic floor disorders as nerve and muscle damage is common. Therefore it is essential to ensure you have a correct diagnosis before proceeding with a pelvic surgery.
Treatment Supported by a Multi-Disciplinary Team
To support you in your treatment, there are multiple specialists that can help you resolve each of your symptoms and ensure they do not return. These include:
- General Practitioner (GP) - Your local doctor is the best place to start when you begin experiencing pelvic discomfort. They can manage a treatment plan which includes referral to one or many of the experts listed below. They will manage the programme of treatment, ensuring communication between the members of the interdisciplinary team, and be part of your support network along the way.
- Nurses - Nurses are important members of any treatment team. They understand the importance of providing complete holistic care, which is essential for sufferers of chronic pelvic pain.
- Midwife - If you are pregnant or have recently given birth, your midwife is in a great position to ensure you are best protected from developing other pelvic floor disorders.
- Physiotherapist - Experts in musculoskeletal disorders with conservative treatments.
- Psychologist - To support you in emotional issues which may occur as a symptom of chronic pelvic pain.
- Sex Therapist - To answer any sexual concerns and help you with your relationships.
- Urologist and Urogynecologist - Experts in treating disorders of the urinary tract.
- Nutritionist - To support you in reviewing your diet for resolution and prevention.
- Friends and Family - With intimate conditions such as chronic pelvic pain, its human tendency to try and resolve it alone. The social isolation that comes with suffering leads to the breakdown of many relationships. Its important that you put embarrassment to the side and be open and honest about your condition. You may be surprised with how common the pelvic pain is, and your openness could help a friend.
- You! - To treat chronic pelvic pain, you need to be honest and open with each member of your treatment team. Embarrassment can be lethal, so don't let it get in your way. Stick to the treatment plan and take advice with an open mind. There will be a lot of education as part of your treatment, and its part of your responsibility to understand the mechanisms behind your pain and how to prevent it from reoccurring.
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