Help!!! My pants are on FIRE!! Wait, what? Well, at least that’s what it feels like to a lot of people with pelvic pain. Because nerve pain can feel just like that – burning, tingling, like fire ants in your pants. In this post we are going to talk about how mediation can help.
Why is this sensation so common in people with pelvic pain? Let’s circle back to our old friend, the pudendal nerve. The pudendal nerve is special. It has nerve fibers that control how the muscles move, it regulates incoming skin sensations AND it has fibers that are linked to the fight or flight nervous system, a.k.a. the sympathetic nervous system.1
Heart pounding, breath racing and blood pressure spiking are all signs of an activated sympathetic nervous system.
Fight or flight mode is on. It’s not always a bad thing to be in fight or flight mode. It has helped us survive over the centuries,but sometimes it gets turned on and stays on,that’s when it becomes a problem. And the pudendal nerve can get triggered via a mechanical problem, such as an overuse injury, surgery, compression, etc.,2 but it can also get triggered when we are in constant fight or flight mode. (For more information on the pudendal nerve, please click here for our collection of archives on the topic).
Luckily we have an “antidote” to the sympathetic nervous system, its calming counterpart,the parasympathetic nervous system. It is the lesser known but equally as important,rest and digest part of the nervous system. Deep breathing, decreased heart rate and increased digestion are all signs the parasympathetic nervous system is in control.3 One way to activate the parasympathetic nervous system is through meditation.
Whether you are chanting the same word over and over again or being guided through a body relaxation, most styles of meditation have the same central focus – being present and deep breathing. Across gender, race and age, meditation is a research proven way to decrease the dominance of your fight or flight nervous system. One study showed that mindful meditation significantly reduced blood pressure, sympathetic nerve activity and heart rate, compared to the control group, in African-American males with kidney disease.5 Another study demonstrated that guided meditation significantly reduced heart rate, sympathetic reactivity and cortisol levels, compared to the control groups, in healthy adult males who were brand new to meditation.6 Even people that have never practiced meditation before can benefit from its positive effects. Meditation is a real, studied and effective way to reduce stress.
The verdict is still out on exactly HOW meditation really taps into the rest and digest nervous system, but one factor that contributes to the relaxation response of meditation is slow, deep breathing. Research shows that when we inhale AND when we breathe slowly, the fight or flight nervous system is inhibited.7 Slow, deep breathing is under the control of the rest and digest nervous system. Just ten minutes of slow, deep breathing significantly lowered blood pressure, heart rate and respiratory rate in people with hypertension.8 Breathing slowly will make you relax. So simple!
Let’s put this all together now. The pudendal nerve has branches of the fight or flight nervous system. Meditation decreases stress and sympathetic activation. Deep breathing inhibits the fight or flight system AND kicks in the rest and digest nervous system. When your pelvic floor is acting up, it will literally help to take a deep breath and meditate. Even though it might be the last thing you want to do when you’re in pain,you can help put out the fire in your pants by slowing down, breathing deeply and taking some time to meditate. It’s not “just in your head,” it’s in your nervous system.
Stop. Don’t Panic. Breathe. Meditate. Not sure how? There’s an app for that (insert eye roll). But seriously, there are several that we recommend here at PHRC, but our top FREE choices are Calm and Headspace. Give it a try and let us know what you think!
- Pelvic Pain Explained by Stephanie A. Prendergast & Elizabeth H. Rummer
- Cortisol as a Marker of Stress by A. I. Kozlov and M.A. Kozlova
- The Pelvic Floor by Beate Carriere and Cynthia Markel Feldt
- http://medical-dictionary.thefreedictionary.com/parasympathetic
- Mindfulness meditation lowers muscle sympathetic nerve activity and blood pressure in African-American males with chronic kidney disease by Jeanie Park, Robert H. Lyles, and Susan Bauer-Wu
- Effect of Meditation on Stress-Induced Changes in Cognitive Functions by Amit Mohan, MD, Ratna Sharma, PhD, and Ramesh L. Bijlani, MD, SM
- Self-Regulation of Breathing as a Primary Treatment for Anxiety by Ravinder Jerath, Vernon A. Barnes, Kyler Harden
- Effects of mental relaxation and slow breathing in essential hypertension by Rajeev M. Kaushik, Reshma Kaushik, Sukhdev K. Mahajan, and Vemreddi Rajesh
FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.
Comments
Thank you for the article and resources!
Once again thank-you for such helpful information.
My nervous system is hyper sensitive to the world – great as an actor/ bad for my pudendal nerve. After 8 years trying to be stronger than my PN I realize the bigger part of the problem is Moi! Have u written more about how PN in a very broad sense is like a auto-immune problem? U know what I mean? I AM my own perpetuator of pain(???)
I think this sympathetic/paradympathetic connection cannot be stressed enough to PN patients who truly want to do the work to heal. Thx again. Ill say hello to NJ for Stephanie if she says hello to my husband in LA and UCRiverside????