by Danica Emery – Physiotherapist

Why endometriosis associated pain requires more than just surgical intervention!

What is Endometriosis?

Endometriosis is a chronic inflammatory condition that results in abnormal growth of endometrial tissue and adhesion sites outside the pelvic cavity. Endometriosis associated pain is not always related to the extent of the lesions and can still occur once lesions have been surgically removed.

What is pain?

Pain is a response produced by the brain to signal actual or potential injury to our body. As such we can experience pain in the absence of tissue injury. So even though your endometrial lesions may have been removed surgically, you can still experience pain.

Endometriosis Associated Pain

Endometriosis may present with painful menstruation, urination, defaecation (passing a bowel motion) and sexual intercourse. Non-cyclical pelvic pain is also common and may present as pain in the abdomen, lower back or pelvic floor muscles.

Endometriosis pain is particularly complex because our brains place high importance on the pelvic area, which houses essential reproductive, sexual organs and organs for waste elimination (bladder and bowel). Persistent inflammation related to endometriosis can cause the nerves in the pelvis and the body to become sensitised. Which may result in a non-threatening stimulus, (eg. going for a walk, urinating) to be perceived as dangerous, resulting in a pain response.

The way we think, and feel can also affect the way we experience pain. If we are tired or highly anxious our bodies tolerance for a perceived “threat or stimulus” is reduced. Meaning pain is more easily experienced.

 

Treatment Options

  1. Education on pain: research suggests that a better understanding of pain can assist in reducing pain.
  2. General exercise: gentle guided exercise (walking, stretching, yoga) helps to improve sleep, boost energy levels and mood, calm the nervous system and may have an anti-inflammatory effect.
  3. Targeted exercises: endometriosis often presents with tightness in the pelvic floor, abdominal and hip muscles. As such targeted exercises to help reduce tightness can be helpful in treating pain associated with endometriosis.
  4. Other non-surgical therapies: manual therapy, acupuncture and electrotherapy (heat, electrostimulation) to the pelvic floor, abdomen and back/hip may help to ease pain and improve function.
  5. Sleep hygiene: when we sleep our body and nervous system restores and regenerates. As such good quality sleep can improve pain.
  6. Mindfulness, meditation and breathing techniques: mindfulness and meditation can help to reduce nervous system sensitivity, thus reducing pain.

A pelvic health physiotherapist can help devise a specific plan for you, utilising the options above, to treat endometriosis associated pain.

If you are experiencing endometriosis or pelvic pain, don’t put up with it, call us to make an appointment with one of our experienced physiotherapists. Call (08) 6389 2947 or click here to book online

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