Chronic Pelvic Pain and Osteopathy
Chronic pelvic pain : Causes, symptoms and management
Definition of Chronic Pelvic Pain
Chronic pelvic pain (CPP) is a complex, persistent, and often debilitating condition that affects many women and men worldwide. It is characterized by pain localized in the pelvic region lasting more than six months and is associated with a significant impairment in patients' quality of life.
Symptoms of CPP
CP is defined as non-cyclical pain in the pelvic region that is persistent or recurrent and cannot be fully explained by specific pathological causes such as acute infection or cancer. It may be accompanied by urinary, digestive, sexual, and musculoskeletal symptoms. Common symptoms include lower abdominal pain, discomfort during sexual intercourse (dyspareunia), pain during urination or defecation, and increased sensitivity in the pelvic region.
Chronic pelvic pain risk factors
Risk factors for chronic pelvic pain increase when the patient :
-
Has a history of pelvic inflammatory disease.
-
Has had a difficult pregnancy or childbirth.
-
Has undergone abdominal surgery or radiotherapy.
-
Suffers from infertility.
-
Has a history of physical or sexual abuse.
Pathophysiology of CPP
The pathophysiology of CPP is complex and involves several mechanisms, including neuro-muscular dysfunctions, abnormalities in pain perception and psycho-emotional disturbances. One central mechanism is central sensitization, a phenomenon in which the central nervous system amplifies pain signals, making non-painful stimuli painful for these patients. People with CPP may also suffer from pelvic muscle dysfunction, visceral adhesions and myofascial restrictions, which exacerbate symptoms.
Chronic pelvic pain treatment
Chronic pelvic pain treatment
Multidisciplinary approach to care
Management of CPP is multidisciplinary, including pharmacological treatments (analgesics, anti-inflammatories, muscle relaxants, anti-depressants), psychological interventions (such as cognitive-behavioural therapies), therapeutic education, and sometimes surgical interventions, particularly if mechanical causes such as endometriosis are identified. However, standard treatments are not always effective, and manual therapy techniques are increasingly integrated into treatment plans to relieve pain.
Osteopathy and manual therapy in the treatment of CPP
Osteopathy and manual therapy are increasingly being recognized as effective approaches to the management of CPP, with studies showing a significant reduction in pain and an improvement in patients' quality of life. Osteopathic techniques include gentle, specific manipulations of pelvic muscles, ligaments and organs, aimed at restoring mobility and reducing tension in the pelvic region.
Manual therapies, such as myofascial release, target muscle restrictions which, if persistent, can intensify pelvic pain. These techniques also promote better blood circulation and reduce inflammation.
