What is Chronic Pelvic Pain?
Pelvic pain is considered chronic when it lasts more than six months. Some patients with chronic pelvic pain go on to develop what is termed Chronic Pelvic Pain Syndrome, with emotional and behavioral changes due to the duration of the pain and stress produced by the discomfort. We have all been taught from infancy to avoid pain, so when pain is persistent and there seems to be no relief, it creates tremendous tension. Also, most of us think of pain as being a symptom of a disease or of tissue injury. In many women with chronic pelvic pain, however, the injury or disease that initiated the pain may have healed or been removed, yet the pain continues without a specific disease as the cause. This leads to a very important distinction between chronic pelvic pain and episodes of other pain that you might experience during your life: usually pain is a symptom of a disease, but with chronic pelvic pain, pain becomes the disease.
There are six basic characteristics of Chronic Pelvic Pain Syndrome:
- Pain is present for six months or longer;
- There is very little relief from conventional medical or surgical treatment;
- Pain is not proportional to tissue damage or the severity of any disease;
- Signs of depression, such as sleep disturbances, constipation, or slow body movements, are present;
- There are limitations of physical activity;
- Emotional roles in the family are altered (wife, mother, partner, etc.).
Chronic pelvic pain is different from other pain that you may have experienced. There usually is no simple single answer to pain relief since the tissue damage has already occurred and further damage has typically stopped. Emotional changes over a long period of time, coupled with behavioral changes, may result in development of Chronic Pelvic Pain Syndrome. It is very important to realize that this pain is not psychological. All chronic pain is neither purely physical nor purely psychological. Rather, due to the chronic nature, it is physical and psychological. The pain is not “in your head” and you are not “crazy.” The pain is real. The pain, however, is usually not dangerous in a physical sense.
Elements of Chronic Pelvic Pain and Pain Management
Some Causes of Chronic Pelvic Pain
General Principles of Treatment
We recognize your suffering. It is our desire to alleviate your pain as quickly as possible. It is very important, however, that we have realistic expectations when dealing with chronic pelvic pain. The pain has occurred over a long period of time and will not go away in a short period of time. Recovery will be a process. Many modes of therapy will be used over the course of your treatment.
We will often ask you to undergo treatments that you might not wish to pursue. However, every measure that we take is well thought-out and has helped many patients. We see our treatment plan as a journey that we take together. Each time we institute therapy, such as trigger point injections, neuromuscular massage, psychological support, or behavior modification, we have thoroughly thought out the implications, and recommended treatment at a time we feel would be most beneficial to you. You can quit at any time, but we hope that you will communicate openly and honestly with us so that we are always treating you in a manner that is consistent with your beliefs and expectations. We are dedicated to your health without reservation. Our promise is that we will always believe you, try to always understand, and will do everything possible to maintain your trust. Please feel free to discuss any areas you do not understand. Unless we have your confidence and trust, we will not be effective.
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