I just got off the phone with a lovely women back east who reinforced a critical concept of pain care: To treat pain effectively, you should treat and, ideally, resolve the source of the pain.
If your pain is coming from a bad tooth, wouldn't you go to the dentist get the cavity filled rather than just take medication for years?
If your pain was coming from a broken leg, wouldn't you want to get the bones aligned and set so that they could heal properly?
Yet, when it comes to pelvic pain, it's far easier to avoid the source, avoid your doctors and go straight to an easy, though short term fix, pain medication. Hey, I'm not against the use of pain medication at all. I think pain needs to be treated aggressively and compassionately and that part of that treatment should be focusing on and, ideally, resolving the source of the pain.
What makes pelvic pain tricky and frustrating, however, is that there are several potential sources of pain. It could be, perhaps, from wounds in the the bladder wall, often characterized by pain which gets worse as the bladder fills with urine that is relieved upon urination. It could be from the tight, spasming pelvic floor muscles, often represented by difficulty starting the urine stream, or a steady, achy burning pain often focused in the vagina. Or it could be from the nerves, strongly suggested when patients have positional symptoms. Patients with a pudendal nerve entrapment often have symptoms when they sit down.
If you've been taking pain medications for years, perhaps its time to reassess the source of the pain. Here are a few suggestions that I think could help.
- Have a pelvic floor assessment to determine if your pelvic floor could be part of the problem.
- Consider having the doctor take another look at your bladder to determine if Hunner's Ulcers could be a part of the problem and, if present, have them treated with a hunner's ulcer therapy such as fulguration, laser therapy or triamcinolone injections.
- Are your symptoms positional?? Do they have an electrical or searing quality to them?? Are they shooting down a leg?? Pay close attention to your symptoms and how they may vary throughout the day and share this information with your doctor.
After having severe and untreated IC pain the first year of my diagnosis, I believe that denying treatment for pain is cruel. Patients absolutely need pain care but we also have to focus on treating the cause of pain.
If your pain hasn't improved, revisit the diagnosis and ask your doctor "Could we have missed something?"
Jill
If your pain is coming from a bad tooth, wouldn't you go to the dentist get the cavity filled rather than just take medication for years?
If your pain was coming from a broken leg, wouldn't you want to get the bones aligned and set so that they could heal properly?
Yet, when it comes to pelvic pain, it's far easier to avoid the source, avoid your doctors and go straight to an easy, though short term fix, pain medication. Hey, I'm not against the use of pain medication at all. I think pain needs to be treated aggressively and compassionately and that part of that treatment should be focusing on and, ideally, resolving the source of the pain.
What makes pelvic pain tricky and frustrating, however, is that there are several potential sources of pain. It could be, perhaps, from wounds in the the bladder wall, often characterized by pain which gets worse as the bladder fills with urine that is relieved upon urination. It could be from the tight, spasming pelvic floor muscles, often represented by difficulty starting the urine stream, or a steady, achy burning pain often focused in the vagina. Or it could be from the nerves, strongly suggested when patients have positional symptoms. Patients with a pudendal nerve entrapment often have symptoms when they sit down.
If you've been taking pain medications for years, perhaps its time to reassess the source of the pain. Here are a few suggestions that I think could help.
- Have a pelvic floor assessment to determine if your pelvic floor could be part of the problem.
- Consider having the doctor take another look at your bladder to determine if Hunner's Ulcers could be a part of the problem and, if present, have them treated with a hunner's ulcer therapy such as fulguration, laser therapy or triamcinolone injections.
- Are your symptoms positional?? Do they have an electrical or searing quality to them?? Are they shooting down a leg?? Pay close attention to your symptoms and how they may vary throughout the day and share this information with your doctor.
After having severe and untreated IC pain the first year of my diagnosis, I believe that denying treatment for pain is cruel. Patients absolutely need pain care but we also have to focus on treating the cause of pain.
If your pain hasn't improved, revisit the diagnosis and ask your doctor "Could we have missed something?"
Jill
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