Pain Relief Center
The pain that comes with Endometriosis can be excruciating and often we find that the pain medication we are giving just isn't working. Here are some things that may work for you.
It is very important to be aware that there are two parts to pain:
1. The stimulus (or cause) of the pain, such as endometriosis. 2. The perception (or processing) of the pain, how your brain receives the pain signals.
There are many different things that influence our pain on a daily basis. Some of the main things that influence us are sleep, nutrition, weather, physical activities, mood and how you are supported in your life.
Pain is our protector, it's a warning to our system of actual or potential danger.
Chronic pain seems to rule our lives, it determines what we do, when we do it and how we do it.
When you have chronic pain it causes nerves to go off sooner and sooner. The more the nerves react the sooner they react. As the pain persists the nervous system becomes more sensitive.
Chronic Pain Spiral
It is very important to be aware that there are two parts to pain:
1. The stimulus (or cause) of the pain, such as endometriosis. 2. The perception (or processing) of the pain, how your brain receives the pain signals.
There are many different things that influence our pain on a daily basis. Some of the main things that influence us are sleep, nutrition, weather, physical activities, mood and how you are supported in your life.
Pain is our protector, it's a warning to our system of actual or potential danger.
Chronic pain seems to rule our lives, it determines what we do, when we do it and how we do it.
When you have chronic pain it causes nerves to go off sooner and sooner. The more the nerves react the sooner they react. As the pain persists the nervous system becomes more sensitive.
Chronic Pain Spiral
- Pain centered life
- Acceptance, education and pain management
- Increased activities
- Improved conditioning
- Improved social function
- Improved self esteem
- Improved motivation
- Function centered life
Physiotherapy
Many women find that Pelvic floor Therapy to be very helpful. Pelvic floor Therapy will help to learn to relax and strengthen the muscles of the pelvic floor.
When I first got to physical therapy I was told that my muscles were very tense and tender. They had very little movement. My main problem area was my back as a whole. I was given a pelvic exam and was told my vaginal muscles were tense as well. She told me that my body reacts to penetration as if harm was being done to my body. At the end of each session I would receive an E-stim massage.
This massage was electronic stickers placed on whatever part of my body in two to for places along with either ice or heat. We started with my back being it was the most tense area and needed the most work. I felt so much better after just one session honestly.
The exercises I was given helped me to gain more movement in all of my muscles. When doing them I had to contract and release my pelvic muscles to help gain control of them.
As far as my pelvic therapy went, I was to lay flat onto a massage table. My legs were bent onto pillows when we first began. She would apply lube onto her finger and then proceed to insert in into my vaginal cavity. When we first began I simply could not take the pain. I would instantly tense up and not allow any further movement. She massaged those muscles that she could reach.
As time passed she made more and more progress massaging areas that needed to be and helped me work on breathing through it. The breathing technique was to breath like I would in my sleep, with my stomach.
Months into therapy my external physical therapy got easy and was a breeze. My internal got so much better as well. She gave me lube to take home and start to do the internal massage at home to help the process.
As time passed and my vaginal muscles relaxed I had to learn to contract and release them while her finger was there. It was hard and long process but now there is no pain with penetration and my overall muscle activity is amazing.
- Story from Marshea Oliver, find more at www.olivershea.blogspot.com or www.medium.com/@olivermarshea
This massage was electronic stickers placed on whatever part of my body in two to for places along with either ice or heat. We started with my back being it was the most tense area and needed the most work. I felt so much better after just one session honestly.
The exercises I was given helped me to gain more movement in all of my muscles. When doing them I had to contract and release my pelvic muscles to help gain control of them.
As far as my pelvic therapy went, I was to lay flat onto a massage table. My legs were bent onto pillows when we first began. She would apply lube onto her finger and then proceed to insert in into my vaginal cavity. When we first began I simply could not take the pain. I would instantly tense up and not allow any further movement. She massaged those muscles that she could reach.
As time passed she made more and more progress massaging areas that needed to be and helped me work on breathing through it. The breathing technique was to breath like I would in my sleep, with my stomach.
Months into therapy my external physical therapy got easy and was a breeze. My internal got so much better as well. She gave me lube to take home and start to do the internal massage at home to help the process.
As time passed and my vaginal muscles relaxed I had to learn to contract and release them while her finger was there. It was hard and long process but now there is no pain with penetration and my overall muscle activity is amazing.
- Story from Marshea Oliver, find more at www.olivershea.blogspot.com or www.medium.com/@olivermarshea
- E-stim massage- this is another word used for TENS machine. See section below.
- Exercises Marshea was given- happy baby, butterfly, sad dog, happy dog, open books, single and double knee to chest, child's pose and knee fall outs. Please see the yoga section here for more information.
Transcutaneous Electrical Nerve Stimulator (TENS) machines
Transcutaneous electrical nerve stimulation (TENS) is a therapy that uses low-voltage electrical current for pain relief. The TENS machine is used to send electricity from the electrodes that you attach to stimulates the nerves in the affected area and sends signals to the brain that blocks normal pain signals from getting to the brain.
See my Livia review here.
Home remedies
- Warm baths (add a bath bomb or some Epsom salts)
- Heating pad or hot water bottle
I have the heating pad that is designed to strap around you and is supposed to be for backs but I use it for both my back and pelvic area. I feel like I should get another one so I can have one on my back and one on my pelvis at the same time instead of rotating.
Chronic pain clinics
Going to a pain clinic to see someone that specializes in pain can be very beneficial. Treatment that could be provided at a pain clinic are:
- Trigger point injections
- Chronic pain groups
- Vitamins and mineral recommendations
- Trigger point injections- a small needle is inserted into the painful area (usually a knot in the muscle, this forms when the muscle doesn't relax) and the area is injected with a local anesthetic and corticosteroids (eases inflammation.) OnabotulinumtoxinA (Botox) is a toxin that blocks signals from the nerves to the muscles are is often used for trigger point injections.
I find that the trigger point injections are really helpful. I get some really bad pains in my back, hips, pelvis, forehead and jaw. I found that the injections actually are able to release some of the tension in my back and jaw. The only thing that I really hate about these injections is that the hurt a lot to get and never last as long as I would like them to. The only relax the muscle for about a month, which I'll take but you always want any relief for as long as possible.
I find that attending a chronic pain group is super beneficial. You will meet other people who also have chronic pain which will help you to feel less alone in your pain. Usually the have an educational aspect to the group where you could learn new information and coping techniques. In the chronic pain group that I attended we learned different stretches and poses that are helpful for relieving tense in the muscles. It was recommended that I increase my magnesium intake.
I find that attending a chronic pain group is super beneficial. You will meet other people who also have chronic pain which will help you to feel less alone in your pain. Usually the have an educational aspect to the group where you could learn new information and coping techniques. In the chronic pain group that I attended we learned different stretches and poses that are helpful for relieving tense in the muscles. It was recommended that I increase my magnesium intake.
Physiological Therapy
Many people have problems handling the diagnoses of Endometriosis and the possibly of infertility and need someone to help them work through the emotional symptoms that come with Endometriosis. Some examples of therapies include but not limited to:
- Stress management- these are techniques aimed at managing your levels of stress to improve everyday function. It is meant for controlling the physical and mental symptoms of stress. This could include mindfulness or meditation.
- Relaxation training- the process of using activities that relax you, this can include deep breathing, meditation or yoga
- Acceptance and commitment therapy (ACT)- working with a professional you will work through the fact that you have Endometriosis and teach you how to accept what is happening to you and to self aware of what you are observing/experiencing.
- Cognitive-behavioral therapy (CBT)- a professional will teach you to better control your thoughts, feelings, sensations etc.
I completed a 12 week chronic pain group where it was a classroom like setting and we learned things like mindfulness, stretches, how to pace yourself, and how to generally cope with the pain daily.
Neuropathy
Endometriosis can cause nerve damage which leads to neuropathic pain. The tissue of the uterus stimulates all the nerves in the pelvis, causing abdominal pain. Endometriosis pushes on the nerves and grow in to the endometrial spots and start to cause neuropathic pain. The types of neuropathic pain that can occur with endometriosis are increased sensitivity to pain and pain due to stimuli that aren’t normally painful.
Sleep Hygiene
Managing sleep problems is an important part in managing chronic pain. Set yourself up for success by using these tips and tricks.
- Maintain good eating habits (avoid meals before bed, limit large amounts of fluid and limit caffeine to 3 cups a day)
- Set up good sleep environment (Quiet and dark room, limit electronics, comfortable bed and bedding)
- Be mindful of activities (active days equal tired nights, plan physical activities 4 or 5 hours before bed)
- Maintain good body position (keep head and neck straight, use soft pillows, use pillow between your legs)
- Maintain sleep routine (keep same wake up and bed times, use an alarm, limit naps to 20 minutes, spend 30 minutes winding down before bed)
Goals, balance and pacing
When making goals for ourselves we want to make sure they are attainable! A good way to plan/set goals is to use the S.M.A.R.T goal method.
S- Specific
M- Measurable
A- Achievable
R- Realistic
T- Timely
Break goals down into steps. Goals give you more control over your day and give you a sense of accomplishment when you complete them.
There are there activity patterns that are most commonly followed
Rest doesn't have to mean lying down or not doing anything. You can change tasks, take small breaks, change position, do some relaxation or meditation.
Think about how long the task is and how long you can do something without getting a flare up. Think about how long it will take you to recover after. Plan for activity time and rest time.
Research shows that people who use time-based pacing actually get more accomplished.
Are you balancing your day to include important activities like self care, productivity, relaxation, leisure, physical activities and proper sleep.
Taking time to focus on our needs and enjoying ourselves reminds us we're alive, important and happy. We tend to forget pleasurable activities. When we are in pain and in a low mood we sometimes feel like we won't enjoy things like we used to, we fear something will go wrong, we think we don't deserve fun things or we're just to much in our heads to enjoy anything.
S- Specific
M- Measurable
A- Achievable
R- Realistic
T- Timely
Break goals down into steps. Goals give you more control over your day and give you a sense of accomplishment when you complete them.
There are there activity patterns that are most commonly followed
- Boom-Bust (over doing it)- Over doing it on a good day and have high pain days after. The over-doer has to get everything done no matter what. They push to get things do and then they crash.
- Wait Until (under-doing it)- People who fear movement will cause increased pain. This person avoids activity hoping to protect themselves from pain. The under-doer stops participating in activities all together.
- Combination Pattern- This person uses the Boom-Bust pattern for some activities and the Wait Until pattern for others. They will over do it for important activities and avoid the not so important activities.
Rest doesn't have to mean lying down or not doing anything. You can change tasks, take small breaks, change position, do some relaxation or meditation.
Think about how long the task is and how long you can do something without getting a flare up. Think about how long it will take you to recover after. Plan for activity time and rest time.
Research shows that people who use time-based pacing actually get more accomplished.
Are you balancing your day to include important activities like self care, productivity, relaxation, leisure, physical activities and proper sleep.
Taking time to focus on our needs and enjoying ourselves reminds us we're alive, important and happy. We tend to forget pleasurable activities. When we are in pain and in a low mood we sometimes feel like we won't enjoy things like we used to, we fear something will go wrong, we think we don't deserve fun things or we're just to much in our heads to enjoy anything.
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