Chronic pelvic pain, or continuous or episodic pain in the lower abdomen or pelvis for at least 6 months, is a common occurrence for many patients at Foundational Concepts.2 If left untreated, this chronic pain has the capability to compromise quality of life, function, and increase the likelihood of psychological impairments.2 Negative thoughts about pain can proceed pain-related fear, and further play into functional disability.5 In order to target pelvic pain, a multidisciplinary approach that includes physical therapy interventions, and emphasizes an improvement in day-to-day pain management and function, should be utilized.2
Chronic pain is more than just a feeling of agony, it is a sensory and emotional experience that is related to how the brain organizes input and stimuli.1,4 Treating chronic pelvic pain should embody a mind-body approach to target more than the muscles and tissues affected but also to retrain how the brain perceives pain.4 Thoughts are considered to be nerve impulses, and research finds that negative thinking can exaggerate perceived pain states.4 However, the thoughts that the nervous system develops about threats and pain can be changed over time.4 Neurons in the brain can become less sensitive and stop misinterpreting a non-threatening stimulus as painful.4 Physical therapy encompasses the “mind-body” approach through manual skills, neuromuscular therapeutic interventions supported by research, and with the development of a unique plan of care to each patient. Practice, persistence, and patience in conjunction with physical therapy, can restore function in a way that does not just mask the pain, but targets the pain.4
There are a variety of ways to make positive thinking a part of your everyday lifestyle. One technique may suit you better, but here are a few places to start:
1. R-E-L-A-X: Research shows that people who mediate better stimulate the region of the brain that is important for attention and regulating emotions.4 In addition, meditation can also decrease anxiety and improve self-confidence.4 Deep breathing, a good tool for EVERYONE (see blog post September 6, 2014) is believed to calm down a hypersensitive nervous system, which exacerbates pain states.4 (Stuck on how to mediate? Refer to our Resources tab for a recorded step-by-step meditation piece.)
2. Exercise: Research supports that exercise can lower a response to stress and improve one’s mood.
-For cardiovascular exercise, the American College of Sports Medicine ACSM), suggests up to 30 minutes a day for 5 times a week, of exercise of moderate intensity (walking, biking, swimming, etc.).4
-Yoga is another great form of exercise that targets body perception, deep breathing, and awareness of one’s mental and physical state.4 Yoga has been shown to increase the amount of positive thoughts and emotions and could potentially reverse the effects of negative thoughts through a physiological effect.4
-Pilates has been found to provide pain relief by increasing flexibility, mobility, and strength. Literature supports that pilates-based exercises provide a significant benefit to reducing pain.3
The small, positive thoughts can become everlasting habits into your day that can better target your pain. Try with just a few positive thoughts to start and see where your mind can take you.
— Lindsay Sureck, SPT
1. Bowering K, O’Connell N, Tabor A, et al. The effects of graded motor imagery and its components on chronic pain: a systematic review and meta-analysis. J Pain. 2013 Jan;14(1):3-13. http://www.ncbi.nlm.nih.gov/pubmed/?term=The+effects+of+graded+motor+imagery+and+its+components+on+chronic+pain%3A+a+systematic+review+and+meta-analysis.
2. Chao M, Abercrombie P, Nakagawa S, et al. Prevalence and use of complementary health approaches among women with chronic pelvic pain in a prospective cohort study. Pain Med. 2014 Oct 3. http://www.ncbi.nlm.nih.gov/pubmed/?term=Prevalence+and+use+of+complementary+health+approaches+among+women+with+chronic+pelvic+pain+in+a+prospective+cohort+study.
3. Sullivan A, Scheman J, Venesy D, Davin S. The role of exercise and types of exercise in the rehabilitation of chronic pain: specific or nonspecific benefits. Current Pain Headache Rep. 2012 Apr;16(2):153-161. http://www.ncbi.nlm.nih.gov/pubmed/22258395
4. Vandyken A, Hilton S. The puzzle of pelvic pain: a rehabilitation framework for balancing tissue dysfunction and central sensitization II: a review of treatment considerations. J Womens Health Phys Therap. 2012 Jan;36(1):44-51. http://entropy-physio.com/wp-content/uploads/2013/10/Central-Sensitization-Framework-Article-21.pdf
5. Vlaeyen J, Linton S. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000 Apr;85(3):317-332. http://www.ncbi.nlm.nih.gov/pubmed/10781906
6. Warner L, McNeill ME. Mental imagery and its potential for physical therapy. Phys Ther. 1988 Apr;68(4):516-521. http://www.ncbi.nlm.nih.gov/pubmed/3281175