APPROACH TO PAIN MANAGEMENT
Management of chronic pelvic pain does not have a one-size-fits-all approach because contributing pain conditions, symptoms, and impacts on quality of life vary so much from person to person. It is essential to find a personalized approach to managing your chronic pelvic pain.
However, there are a few common strategies that are generally helpful for effectively managing chronic pelvic pain, regardless of your specific symptoms or contributing pain conditions.
Wholistic
So many people with chronic pelvic pain say that it’s not just the pain that bothers them – it’s the fact that having pain all the time ruins their sleep, drains their energy, and robs them of the ability to fully participate in their lives. In addition to using effective treatments for individual pain conditions, we want to also help you manage all the ways that chronic pelvic pain impacts your life.
Multimodal
People with chronic pelvic pain are likely to benefit from multimodal treatment – in other words, using a combination of several treatment strategies at the same time. The goal is to develop a comprehensive plan that addresses both individual pain conditions and other issues impacting your quality of life.
It may be helpful to think about treatment of pelvic pain as a toolbox. You will probably be given some long-term tools, like pelvic floor physical therapy or hormonal suppression, that can help address the underlying issues contributing to pain. But you also need some short-term tools, such as acupressure, relaxation techniques, or medications, that can help make the occasional pain flares more tolerable or less disruptive to your life.
Communication with health care team
Doctors and other health care providers can use procedures, therapies, medications, and devices to manage individual pain conditions and to help you modify how the brain processes pain; but the person with the best access to your brain is you. Thus, the best approach for managing chronic pain is a partnership between what your doctor can do (i.e., professional care) and what you can do (i.e., self-care).
We’ve all had the experience of leaving a health care visit and feeling like we didn’t get to address the issues that were most important to us. It can feel extremely overwhelming to review your history again and again, or quickly summarize symptoms that vary so much from week to week. Your health care provider may also feel overwhelmed trying to get all the necessary information they need from you to make thoughtful and accurate recommendations in a limited amount of time.
It can be helpful to bring a short list of questions and start the visit by mentioning that you’d like to discuss the one or two issues that are most important to you. This can help you and your health care provider budget time effectively during your visit. It is also extremely helpful to take a few notes about changes in symptoms since your last visit and to spend some time before the visit thinking about any changes in medications, activities, stress or other issues that may be related to this change. Finally, it is absolutely acceptable to ask for a sooner return visit to finish discussing questions that you didn’t have time to address during that visit. Your health care provider may be able to address quick questions or request for clarification over a portal message or phone call, but it may be necessary to have a scheduled virtual or in-person visit to have enough time to answer a more complex question or change treatment strategies.
Set goals
Of course, both you and your health care providers want you to be pain-free. Unfortunately, chronic pain conditions tend to be long-lasting, and may not completely resolve. However, most people with chronic pelvic pain are able to find strategies to effectively manage their pain so that daily pain decreases and pain flares become less intense or less frequent.
Rather than setting goals that focus on pain intensity or a “number” on a pain scale, many people find it helpful to have a goal of being able to do a specific activity without pain interfering or making them stop. This looks different from person to person and depends on what is going on in your life right now. Some people may set a goal of not needing to miss class or work more than once per month because of pain. Other people may have a goal of being able to sit on the floor and play with their kids for 10 minutes every day. Another person may have a goal of being able to have sex with their partner without bothersome pain.
Think of two or three things that you’d really love to be able to do without pain stopping you. Make it realistic – maybe running a marathon this year or walking around an amusement park all day are too ambitious goals to begin with. You can certainly make new, more ambitious goals as you are better able to manage symptoms.
Tracking progress
The truth is that there is no magic bullet for treating chronic pelvic pain. Progress takes time. Most people with chronic pelvic pain feel that symptoms vary over time, and it is common to experience pain exacerbations even when you are using a very effective treatment regimen. It is helpful to keep track of the general trajectory of symptoms. Some people find that symptom trackers can be helpful to monitor the bigger picture of symptom control.