Last week I was able to attend the annual conference of the International Pelvic Pain Society (IPPS). This organization serves to educate professionals as well as the public about pelvic pain, and bring hope to those who deal with pelvic pain that there is help. Every other year the conference is held in Chicago, a great city where I can enjoy a little cooler weather, see friends, and just take a small break from the crazy that is life.
I arrived ready to learn and to catch up with colleagues. One of the best parts of conferences is seeing other physical therapists who I rarely see in person. We spend most of our time connecting online, through social media and other outlets. Seeing them face to face is always a welcome bonus. What I love even more is meeting and speaking to other health care professionals who work with these patients. Another highlight of this particular conference is the collaboration that occurs with ALL members of the health care team - physical therapists, doctors, nurses, mental health professionals to name a few. Clinicians and researchers coming together for one purpose. There is mutual respect and sincere curiosity for how the others approach pelvic pain and how we can all work together. Egos are checked at the door and this is the beauty of it all. Even when we don’t agree we are all willing to listen, debate, and discuss in a professional manner. In a professional world where opinions and biases can create unnecessary conflict, the willingness to listen and learn in this group, even when we don’t always agree, is what keeps me coming back.
Here are a few tidbits of what I took away from this year’s conference:
You cannot treat pain without looking at the brain. In fact, the brain changes with pain – the way it responds to stimuli AND the way it interacts with other areas of the brain. Many studies show this. This is NOT the same as saying “it’s all in your head.” It IS in your brain AND your body.
Certain treatments, such as Cognitive Behavioral Therapy, serve to change the brain as well, showing that these types of treatments can help improve pelvic pain symptoms.
What used to be thought of as linear – the driver for pain is in the local tissue or it’s a central driver in the brain – is now seen as more robust, with contributions from both local and central drivers. This creates a unique pain experience for each patient.
The experience of pain is influenced by many systems in the body – muscular, nervous, endocrine – and now we are also seeing that some chronic pelvic pain may be driven by a response in the immune system! Take home: pain is complex and to treat it we must adopt a true multidisciplinary approach.
Pelvic Girdle Pain (PGP) is a musculoskeletal disorder independent of urological or gynecological causes. It can affect up to 20% of women in pregnancy and continues in many in the postpartum period. It has a significant impact on quality of life.
Many women with PGP do not report it to their healthcare providers, therefore it is under-diagnosed.
The cause of PGP is not known, and potentially a combination of hormonal, biomechanical and neuromuscular factors.
The best type of exercise for women with PGP is individualized, supervised and blends a home program with regular follow ups with a clinician.
Vulvodynia is associated with increased pelvic floor muscle tone / tension. Treatment may include interventions aimed at both active and passive components of muscle tone.
Mindfulness involves tuning into pain. This technique can be effective when treating pelvic pain.
I love that every year there is more to learn and more to share. I hope that this leads to more people getting the h
elp they need for things like pelvic pain, urological and GI dysfunction and other conditions that may affect the pelvic floor.