Pelvic Pain Information
St. John OB/GYN Professionals - Chronic Pelvic Pain Clinic
We would like to offer a brief overview of chronic pelvic pain and provide education about healthy behaviors you can engage in to become an active part of the management of your pain.
Chronic pelvic pain (CPP) is a complex problem that can be caused by may interrelated processes. It can be cyclic (occurring with menses), constant, episodic, or it can be brought on by specific triggers, such as sexual intercourse. It can be related to various organ systems, including the urinary tract, genital tract, musculoskeletal system, circulatory system, and nervous system. It is frequently also affected by (but not necessarily caused by) psychological factors. Most of the time, more than one of these factors is involved.
A CPP patient will frequently have pain pathways in the central nervous system (brain and spinal cord) that are not working properly. Picture this as if someone has turned the volume knob in your spinal cord, and the pain now sounds louder than it is supposed to sound. One of the things we may do is to help you turn down the volume knob with medications, exercise, and other therapies.
Here are some measures you are able to carry out yourself to help turn down the volume on your pain. Most of the general considerations related to self-care in patients with CPP are generally healthy behaviors that also have other health benefits. Examples of these behaviors include:
- Healthy diet
- Adequate sleep
- Adequate physical activity on a daily basis
- Avoiding unnecessary physical and psychological stressors
- Managing other illnesses
You should try to eat a wide variety of food from the different categories, avoiding any specific foods that make your pain worse. Usually, fresh fruits and vegetabls, whole grains, low-fat dairy products, and lean meats (including fish) are the core of a healthy diet. For more specific information on a health diet, please see www.mypyramid.gov. Depending on your specific condition, there may be additional dietary advice that will be discussed with you in the office.
Different people need different amounts of sleep. Most people require approximately 8 hours of uninterrupted sleep per night to function optimally. You may require a little more or a little less. Too little sleep can result in poor physical and mental functioning, excessive daytime fatigue, and difficulty controlling your pain, as well as other health problems. People who get appropriate amounts of sleep respond better to medical treatments. The initial step in attempting to get better sleep is called "sleep hygiene".
This involves having a regular time to go to bed and wake up and a regular nighttime routine. It includes avoiding watching television when you are in bed and not allowing you normal routine to be disrupted unless absolutely necessary. If you have insomnia (inability to get to sleep or inability to stay asleep through the night), you may need medical evaluation and treatment. Please let us know if you feel that this is a problem for you.
Staying (or becoming) physically active is a very important part of a healthy lifestyle. Some people, for example those with highly physical jobs, get plenty of physical activity through their daily activities. Most people, however, need to make a conscious decision to be more active. A regular regimen of aerobic exercise and/or strength training help to recondition pain pathways and can be a key part in the management of your pain. Too much exercise at one time can make your pain worse. Think of this like taking a vitamin. You would not want to take 7 vitamin pills once a week; you would take 1 each day. In the same way, exercise is better when spread out over time, rather than lumped into a long session. Thirty minutes of moderate physical activity per day is a general guideline for health exercise. You may be prescribed specific exercises or formal physical therapy, depending on your condition. Even if you are not prescribed a specific regimen, it is a good idea to stay physically active, both for your own pain management and for your long-term health.
Stress is a normal part of life. It can be felt both mentally and physically and frequently helps us stay on track with important tasks. We can, however, become overstressed in ways that are not healthy, and this can turn up the volume knob in our pain pathways. One way of avoiding excessive stress is by careful planning, so you are not overworking yourself under the pressure of a quickly approaching deadline. Another important part of stress reduction is having adequate social support. This is one way that your family and friends can help you manage your pain more effectively by keeping the volume knob from getting too high in your spinal cord. Taking time for yourself, even just a short break during the day, can often keep your stress at a healthy level. If you feel like stress is a major factor in your life, let us know.
People who have multiple medical illnesses or conditions will often find it overwhelming trying to keep everything under control. We often find that one condition will affect another and vice versa. Sometimes even the treatments for one condition can affect another condition in a good or a bad way. Sometimes we may need to talk to your other doctor(s) to make sure any treatments we are planning won't interfere with any conditions they are treating or monitoring for you. It is important that you continue to see your regular doctor(s) for whatever other medical illnesses or risk factors you might have and to follow their advice to keep yourself as as healthy possible. We are always willing to answer any questions along the way.