PELVIC PAIN CONDITIONS
Persistent or chronic pelvic pain is very debilitating for women and men. Persistent pain can affect a person’s ability to work, affect their relationships and decrease their sense of well-being. Changes in approaching the management of persistent pain has occurred by adapting the work of the Adelaide physiotherapists and pain researchers, Lorimer Moseley and David Butler and incorporates the importance of the brain in understanding about the perpetuation of pain.
Central sensitization of pain (or central pain mechanisms) means that rather than only focusing on the ‘peripheral organ’ (the vagina, the bladder, the bowel or the ano-rectal region etc) we are now looking at a multi-dimensional approach to treatment, which importantly, includes the brain. It is very helpful to go to a link of a blog I have collated of many pain-related articles to help you understand this brain/pain link before the initial appointment. It can be quite a shock to you to hear your physiotherapist talking about the brain, when your pain is in your vagina, your coccyx, your anus or another part of the pelvic region, and having pre-read some or all of the links can set you up for a greater understanding immediately.
Be reassured that our pelvic health physiotherapists will be listening carefully to your story, assessing your pelvic floor and other areas that may be implicated in your pain (such as your thoraco-lumbar spine, pelvic nerves) and giving you an individualised treatment plan and home programme to help you not only manage your pain more effectively, but also hopefully return to a pain-free life.
Should COVID restrictions suddenly change, or you are unwell on the day of your appointment or you are not in Brisbane and are unable to attend the rooms, you can book a one-on-one Telehealth consultation. Either a face-to-face appointment or a Telehealth appointment takes up to 1.5 hours with education a key component of the initial appointment. Your physiotherapist may suggest vaginal dilators (a treatment modality used for graded exposure to having something in the vagina and also to massage muscle tightness in the pelvic floor muscles) and these are available to purchase at the rooms for an extra cost on top of the consultation.
Persistent pain responds well to strategies such as those in yoga, breath awareness and general body relaxation and so to help this we have a special class to help with pelvic floor muscle down-training, body scanning relaxation and breathing exercises. We call it Yin Yoga for Pelvic Health. In recent times, we have found these classes very useful in learning how to deal with the sudden dramatic changes in your work, health and family situation. Anxiety builds as the changes hit your financial, physical and mental well-being and so even if you don’t have persistent pain, but rather generalised anxiety, I would recommend trying this class. The class is intended for therapeutic nurturing, designed to help you unwind and tap into your body’s natural rest and recovery mode. Gentle stretches are held for a longer period of time to release deep held tension with breath focus and meditation woven throughout. It is a wonderful class to help you relax the pelvic area in particular to create balance in the whole body. We will gently guide you through each pose with modifications and options. Sitting and lying still focusing just on the breathing and meditation is also an option for your 45 minutes of self care. It is conducted by a pelvic health physiotherapist, Amanda Lee, via a zoom link into your very own living room. A comfortable floor space, a yoga mat, some cushions, bolster, strap and yoga block are suggested as useful equipment if you have these. No prior experience in yoga is necessary.
Whether you live with persistent pain from migraines, endometriosis, overactive pelvic pain (which can be manifested in sexual dysfunction for both women and men) or low back pain, this class will provide self-healing strategies such as stretches to help nerves slide and glide; take you through full body relaxation allowing tense muscles to down-train and soften; there will be mindfulness and breath awareness and generally reinstating a sense of calm in your body.