By PHRC Admin
In a world where we’re accustomed to physical discomfort being temporary, it’s hard to imagine what living with chronic pain feels like. It’s not just an ongoing ache or discomfort. It’s a complex, multifaceted experience that can seep into every aspect of life, making even the simplest tasks daunting. Explaining chronic pain to someone who hasn’t experienced it can be challenging, but analogies and clear, descriptive language can help.
Chronic pain is like an uninvited guest that overstays its welcome, persistently lingering no matter how much you wish it away. Unlike acute pain, which acts as our body’s alarm system alerting us to an injury or illness, chronic pain is akin to a broken alarm that continues to blare long after the threat has passed.
Our patients often tell us one of the main struggles is that they look totally ‘normal’ and ‘healthy’, yet they may not be able to sit, exercise, have sex or even wear underwear. We understand they may feel like they are distracted by constant urges to urinate or they are afraid to have a bowel movement. We know all too well explaining pelvic pain and dysfunction adds an extra layer of stress and embarrassment. We strive to educate suffering patients and their families to help reduce embarrassment and help people advocate for themselves for proper diagnosis and treatment. This blog includes general suggestions for talking about pain and direction towards resources specific to various pelvic pain pain diagnoses that can be shared or used for discussion points in your conversations. We hope this makes the journey less difficult. If you are struggling and need our help in person in one of our 11 PHRC locations or via digital health we are here for you!
General Information: Discussing Pain
Our clients often paint a vivid picture of their experiences. They describe it as if they are living in a body that’s perpetually on high alert, constantly bracing for the next wave of discomfort. The invisible nature of their pain can lead to feelings of isolation, as others may not fully comprehend the depth of their struggle.
Other analogies to share when trying to describe chronic pain to someone who’s never experienced it:
- The Broken Alarm Clock: Imagine a faulty alarm clock that goes off at random times throughout the day and night. No matter how many times you try to switch it off, it persists in ringing. Chronic pain is like this broken alarm clock, relentlessly sounding off, disrupting your life at unpredictable intervals.
- The Persistent Echo: Consider the echo in a mountain range. You shout once, and the sound reverberates again and again, long after you’ve stopped making any noise. Chronic pain is like an echo, a response to an old injury or illness that keeps resonating in your body.
- The Static on the Radio: Think about trying to listen to your favorite song on the radio, but there’s a persistent static noise overlaying the music. No matter how you adjust the frequency, the static never completely disappears. That’s chronic pain – a constant interference, a noise that overlays everything you do and experience.
- The Overcast Sky: Picture a day with an overcast sky, where the sun is continuously hidden behind the clouds. The gloominess persists, casting a shadow over everything beneath it. Chronic pain can feel like this – a persistent cloud cover that dims the brightness of life.
- The Heavy Backpack: Imagine carrying a heavy backpack all day, every day. It weighs you down, makes every task more difficult, and you never get to set it down. That’s what chronic pain can often feel like – a constant, burdensome weight that you can’t get rid of.
According to the Centers for Disease Control and Prevention, around 20% of U.S. adults live with chronic pain, highlighting the critical need for understanding and addressing this widespread issue1.
At our clinic, we’re committed to shedding light on this often misunderstood condition. We strive to help individuals navigate their journey with chronic pain through education, support, and effective management strategies. Our goal is to empower our patients to live a life free from the constraints of chronic pain.
Remember, chronic pain is a journey, but it’s one that no one should have to walk alone. With professional guidance, a supportive community, and personal resilience, it’s possible to reclaim control over your life.
Pelvic Pain Resource Guides by PHRC
Vulvodynia, Vestibulodynia, Vaginismus
Chronic Pelvic Pain Syndrome/Chronic Prostatitis
Interstitial Cystitis/Painful Bladder Syndrome
Sources
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Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
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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.