How does pelvic pain spread?

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• The pelvic area specifically refers to the bowel, bladder and reproductive organs.

• When this pain lasts for 6 months or more, it is defined as chronic pelvic pain (CPP). CPP can be viewed as a single condition, but it is also a cluster of symptoms that overlap with other health conditions such as endometriosis, urinary tract infections, pelvic myofascial pain, vulvodynia, bladder pain syndrome and irritable bowel syndrome

• Pain is not always physiologically observed in the body, which can be discouraging for both patients as well as specialists involved in their care. Sometimes the level of pain experienced is greater than the expected severity and doesn’t necessarily match up as far as tissue damage and inflammation are concerned.

• For example, endometriosis sufferers report pelvic pain with varying bowel and bladder symptoms, but these don’t seem to correspond to the location and extent of the disease

• Central sensitisation is when the nervous system moves into a state of reactivity and the body becomes hypersensitive to pain signals

• Due to the reactivity, the threshold for what causes pain is lowered so a small tweak could cause pain even if previously it wasn’t painful or something that was already painful before, causes more pain than it should or is expected.

• Peripheral sensitisation is a reduction in pain threshold and an amplification in the responsiveness of pain receptors.

• In many people with chronic pain, the baseline level of activity is higher in the nerves and so it only takes a small stimulus to reach threshold and for pain signals to fire.

• when one area in the pelvic region starts to experience pain, pain can also arise in normal tissue/organs that are close in proximity to the original pain site as a result of shared neural pathways

• Pain is typically considered more threatening when we’re not sure what’s really going on

• Anticipation of pain increases the perception of threat and activates brain regions involved in both the sensory and emotional intensity of pain, priming a stronger initial pain response

• reducing hypervigilance and refocusing attention where possible helps to decrease physical tension and stress, both of which are associated with increased pain experience. Refocusing attention might look like focusing on your breathing, using the 5 senses to shift your attention to the present moment, connecting with nature, or doing something completely different as distraction.

• Shared experiences and support is a powerful tool

• Acknowledging and naming how it makes you feel helps with resistance and can create some space between ourselves and our emotions