Managing Chronic Pelvic Pain
Chronic pelvic pain is pain that occurs in the abdomen or pelvis for longer than three to six months.
It can be a mild pain or a debilitating one. Either way, if you’re suffering from chronic pelvic pain, you should seek treatment.
“I recommend speaking to your doctor about any pain you have that is new or different. Especially with the pelvic area as there are so many issues that could occur and it is important to rule out things like infections to find the cause,” said Melanie Millstein, a physical therapist who specializes in pelvic health conditions at the Washington DC VA Medical Center.
A physical exam can help to identify what is causing pelvic pain. Millstein said that just because the pain is in the pelvis, doesn’t mean the source is.
“Often times we hyper focus on the location of the pain when an injury or issue outside of that area is actually contributing to it. That can be the case with chronic pelvic pain, so we look at things like tightness in the back or hip muscles that may be causing issues further down.” she said.
Other common causes of pelvic pain include:
- Pregnancy or Multiple Pregnancies
- Complications with birth
- History of trauma
- History of sexual trauma
- Endometriosis
- Hysterectomy
- Irritable bowel syndrome
- Poor diet
- Bad sleep hygiene
- Anxiety
Conditions like endometriosis or cysts, may be cured through surgery. Others, like irritable bowel syndrome or muscle spasms may be treated with medications. When chronic pelvic pain is caused by factors that are harder to cure, VA provides physical therapy and behavioral pain management programs to help manage pain levels. That is where Millstein comes in to study the body’s mechanics and work with the Veteran to develop a treatment plan that addresses their needs.
“We can make changes in things like bowel and bladder habits, posture, sleep hygiene and diet and so much more,” she said. “If there is an activity that you want to get back to doing but it causes you pain, we can create small goals to gradually expose yourself and work up to doing that activity.”
Some treatments options for chronic pelvic pain include learning techniques to:
- Strengthen the pelvic floor
- Strengthen the core
- Reduce muscle tightness in the pelvic area
- Increase range of motion in the hips
- Improve joint mobilization
- Relax muscle groups
Chronic pelvic pain sufferers may deal with mental health struggles associated with their condition. Millstein encourages patients to develop a five-minute routine they can accomplish, even on the days when the pain is unmanageable, to help them feel in control.
“Our bodies are going to change day-to-day as our personal life and stressors influence them,” she said. “So, focusing on what we can control is so important. If you have a routine you can complete, no matter what, it helps to stay focused and remember that tomorrow is going to be a better day.”
Chronic pelvic pain affects men and women, but is more commonly found in women, who may mistake it for routine premenstrual syndrome symptoms. Millstein said if you find yourself bed ridden for the first few days of a period, it is not normal.
“As females we often think debilitating pain is a part of our cycle. It’s not,” she said. “Ask your doctor if there are other things that could be contributing to it. Let us help you manage your chronic pelvic pain so you can get back to doing the things you love.”
If you are suffering from pain in the abdomen or pelvis that has persisted for more than three to six months, speak to your VA primary care provider about chronic pelvic pain. Learn more here: Chronic Pelvic Pain - Women Veterans Health Care (va.gov)