It’s important for you to learn about persistent (chronic) pelvic pain (PPP) and different strategies that may help you. Research suggests that learning about pain can lead to a gradual reduction in pain. It can help you understand your pain and find ways to manage it better.
What is pain?
The pain response
Why does some pain become persistent?
Pain doesn’t mean your condition is getting worse
How your thoughts influence pain
You can retrain your brain
Pain is a protection system to keep us safe. It’s how our brain signals to our body that there is potential danger. Pain makes us act in a way that protects us from further harm.
Everyone experiences pain differently. You may feel different sensations, such as throbbing, aching, stabbing, burning, cramping or shooting pain.
Pain is a complex condition that’s influenced by many different factors. But regardless of the cause, the pain is always real.
Your brain produces pain when it interprets that you are in danger and need protection. When there is potential danger to your tissues (e.g. when you touch something hot), special nerves send messages about the danger through your spinal cord to your brain. Your brain interprets these messages, which results in a pain response (i.e. you feel pain).
Your brain considers physical factors (e.g. type and location of injury) and non-physical factors (e.g. past experiences and emotional state) before deciding what to do.
Pain comes from your brain, not your body tissues, so two people can have the same injury and respond differently.
Watch this YouTube video to learn more about the pain response.
Persistent pain happens when your nervous system becomes overprotective.
When danger messages are repeatedly sent to your spinal cord, it ‘increases the volume’ of these messages before sending them to the brain. When your brain receives these louder messages, it’s more likely to produce pain.
This process causes your nervous system to become more sensitive. For example, it may respond to normal sensations such as hot, cold or movement as if they are dangerous and your brain will produce more pain to protect you.
Once your nervous system becomes overprotective, anything can set it off – even thoughts.
Persistent pain isn’t usually related to an injury or an underlying condition getting worse. It’s more likely related to increased sensitivity of your nervous system. Your nervous system may be stuck on ‘high volume’, making you feel pain in different areas or stronger pain than normal.
If you worry that your pain is due to an injury or condition, you may avoid activities or certain movements. This can limit your ability to function and may lead to more pain.
When you have persistent pelvic pain, your nervous system can lose its ability to be specific. So a sensation in one pelvic organ may produce a pain response in other pelvic organs, or in different parts of your body, such as your skin or muscle. This can become a vicious cycle, where pain makes the nervous system more sensitive and pelvic organs become more sensitive to different sensations.
Your thoughts can influence your pain experience. It’s important to remember that pain is your body’s way of protecting itself.
Most of the time, pain is useful. But if pain continues after tissues have healed and danger has disappeared, it’s no longer useful. When you anticipate pain, it can increase the pain response. This can lead to higher levels of stress and anxiety, which may make the pain worse. Over time, this vicious cycle can make it harder to cope.
But you can try different things to change your thoughts about pain. For example, you can remind yourself that pain flares do not necessarily mean your condition is getting worse, and you can try to move normally. When you continue with activities you enjoy, your body releases feel-good chemicals (endorphins) that can improve your mood and reduce your body’s response to pain. This mindset will help you to feel more in control of your pain. It may also reduce your pain.
Your brain can constantly adapt to changes in your body and the environment. With persistent pelvic pain, if you repeat certain thoughts, feelings and behaviour, it can lead to a more sensitive nervous system. This can make your pain worse.
But you can retrain your brain to reduce your pain. For example, you can try different activities, such as meditation and yoga, or see a psychologist to learn how to manage your thoughts about pain. A pelvic floor physiotherapist can also help you learn more about your pain.
You don’t have to do this alone. Work with your healthcare team to develop a plan that’s right for you.
Retraining your brain takes time and practice. But when you use these skills regularly in your daily life, you will notice improvements in how you experience pain.
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at May 2023.