Chronic Pelvic Pain is no new kid on the block. With that said, chances are most of you have probably never heard of it. A silent epidemic, this condition affects approximately 30 million women at any given time, and that’s in North America alone. That means that 1 out of 3 women will experience CPP at some point in their lives. If that number sounds like a lot, that’s because it is.
So why have you never heard of it?
Many women who experience sexual pain feel an overwhelming amount of shame and confusion when confronted with this condition, often leading to a sense of guilt and ultimately isolation. The pain itself as well as loss of libido and infrequent sexual intercourse can often cause a women to feel as though she is “broken” or “less than”. Unfortunately most women don’t feel comfortable confiding in friends or loved ones, because they think discussing sexuality (or lack of) might be considered taboo or inappropriate. What’s even sadder is that when they do build up the courage to discuss it with a physician they are often dismissed and told that the pain is “all in their head” or that there are no effective treatments or cures. An astonishing 61% of women who suffer from pelvic pain do not get a definitive diagnoses.
The end result? Physicians often misdiagnose or simply don’t diagnose the condition at all and are generally quick to prescribe a pain killer or opioid to ease the discomfort (temporarily).
Here’s where it gets dangerous.
By introducing these highly addictive drugs into the body without diagnosing and curing the core issue, a vicious cycle of dependency is created. Patients are left on a carousel of medications due to lack of proper evaluation and treatment strategies.
Where’s the harm if it makes the pain feel better?
Masking the pain is quite different from treating it. Pain killers are meant to be taken for a short time in order to facilitate a healing period post surgery or procedure. These can range from something as simple as extracting your wisdom teeth, through orthopedic surgery.
Sounds innocent enough, doesn’t’t it?
As short term solutions for dealing with a properly diagnosed condition, these medications can be quite helpful. However when that is not the case, patients are given prescriptions for a longer period than necessary increasing the probability of the body becoming tolerant or addicted to the substance.
When these drugs enter the body, not only do they create side effects such as increased sensitivity to pain, nausea and depression but they are also known to create physical dependence and tolerance to the medication. Essentially what that means is that your body will need an increased dosage over time in order to attain a consistent level of effects. Any attempts to decrease or stop use altogether are usually met with severe withdrawal symptoms.
The most common type of addiction begins following a medical procedure, which means that it can affect anyone. This caliber of medication introduces an addictive nature to one’s body that knows no faces. It does not target folks who have a history of substance abuse or addiction. It targets anyone it comes into contact with.
Here’s what generally tends to happen. You have a routine procedure and receive a prescription for a painkiller. You take the required dosage but experience side effects, which cause you to introduce new medication(s) to deal with those side effects. If your original condition is not properly treated, over a period of time not only does your body get hooked on the painkillers but you also need more in order to feel the effects. That means more additional meds to deal with those side effects. And so begins the cycle of addiction.
A Silent Health Emergency
Chronic Pelvic Pain and opioid abuse are unfortunately strongly linked and rarely talked about in our society. Due to the private nature of issues dealing with the pelvic area, women are often unsure of where to seek help. The feelings of shame or embarrassment tend to overpower the ability to confide in family and loved ones, which creates a sense of isolation. Inevitably this leads them to speak with their general physician who is often unfit to diagnose or treat the issue causing them to prescribe something that masks the pain. Because pelvic pain is a topic that is rarely discussed, women tend to begin medication with the hopes that it will remedy what they are feeling both physically and emotionally.
Over time women usually realize that not only are the opioids not healing their multifaceted pain but unless they take more, they feel increasingly worse. Unfortunately by the time they recognize this their body is already hooked and most attempts to decrease their intake is met with fierce withdrawal symptoms. In turn this creates an additional wave of guilt and embarrassment associated with their condition. Not only do they feel inadequate as a woman, they now are ashamed of feeling like a substance abuser. This generates even more feelings of isolation and depression.
At this moment there are two very different scenarios that can occur.
Women like Jamie Lee Curtis, who recently went on record as a recovering opioid addict are fortunate enough to have the resources and support systems needed in order to confront and overcome their addiction. Other not so fortunate cases are often met with tragic endings. What makes this particular type of substance abuse so much more dangerous than others is that there are usually very few warning signs regarding levels of addiction and overdose, resulting in an invisible epidemic.
What You Need To Know
Opioid prescriptions have quadrupled since 1999 and is currently a 3 billion dollar industry.
Pain killers and opioids have become the leading cause of death in the United States.
In 2014 there were 2 million recorded cases of Americans that abused or were dependent on opioids and recent studies have shown that 78 Americans die every day from an opioid overdose. In fact, from 2000 – 2014 alone, nearly half a million people have died from drug overdoses related to these medications.
The most common types involved in opioid overdose are: oxycodone (OxyContin), hydrocodone (Vicodin), and methadone.
Overdose cases also involve the use of benzodiazepines which are used to sedate, induce sleep, prevent seizures, and relieve anxiety. The most common benzodiazepines are: alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan).
You should avoid taking opioids and benzodiazepines whenever possible. Together they create a dangerous cocktail that could easily end in tragedy.
How Does That Relate To You?
Being educated in the various methods of treating Chronic Pelvic Pain is the first step in making healthy choices when it comes to your body. In most cases, this condition can be treated through alternative methods that do not call for highly addictive prescriptions or harsh side effects.
For those of you who are struggling with Chronic Pelvic Pain or any consistent pain please note:
– Pelvic pain is a condition that can be treated without the use of opioids or pain killers. The American Urological Association recommends pelvic physical therapy as the first line of defense for pelvic pain and urological disorders.
– Chronic Pelvic Pain can be correctly diagnosed by a pelvic physical therapy professional through a series of tests to decipher whether it’s sex related, bladder related, organ or nerve related or vulva related. Once this has been established the proper strategy can be created to treat the condition.
– Through internal stretching and myofascial massage we have been able to successfully treat 59% of our Chronic Pelvic Pain patients.
Take Control of Your Pain
– Seek out alternative options such as pelvic physical therapy before making the decision to depend on pain medication.
– Write your local statesman regarding your concern about these issues and ask that they encourage physicians to prescribe alternative therapies as a first line of defense when treating pain conditions. Having a prescription for pelvic physical therapy will increase the chance of being reimbursed by your insurance company.
– If you think you might need help overcoming addiction, reach out to your local Narcotic Anonymous to find out what options are available to you as a first step in taking your life back.
Chronic Pelvic Pain is real. It is not in your head and it is nothing to be ashamed of. If you are experiencing pelvic pain or discomfort, align yourself with practitioners and therapies that help you to diagnose the condition and create a proper treatment strategy with you.
Remember that with the proper guidance, dedication and hard work you can successfully take control of your pelvic pain without turning to medication.
For more information or if you have additional questions, please feel free to contact us at Renew Physical Therapy- 212-213-4660 or email us at [email protected]
Center For Disease Control Guidelines for Prescribing opioids for chronic pain. March 2016
CDC. Vital signs: Overdoses of Prescription opioid pain relievers—United States, 1999–2008. MMWR 2011;60:1487–92.
Journal of the Society of Laparoendoscopic, C. Paul Perry.Current Concepts of Pelvic Congestion and Chronic Pelvic Pain 2001 Apr-Jun; 5(2): 105–110.
Fitzgerald CM, et al. Pelvic floor muscle examination in female chronic pelvic pain. J Reprod Med. 2011;56(304):117–122.
Contemporary OB/GYN, Deborah Coady, MD, FACOG August 2015
CDC. Injury Prevention & Control: Opioid Overdose