Understanding Chronic Pain

The pain’s not all in your head – but your head can help control it.

Chronic pelvic pain impacts upwards of 15% of premenopausal women. Endometriosis is a common culprit, but even in this condition, the pain doesn’t always correlate well with the amount or severity of endometrial lesions.

This is similar in other chronic pain situations – low back pain severity doesn’t correlate with the actual amount of physical damage! Meaning someone with severe pain can actually have less physical damage compared to someone who has much more physical damage.

Why is this?

Those with chronic pain often demonstrate an increased pain sensitivity. Now, this doesn’t mean it’s all in your head or that you are weak in some way. This increased sensitivity is real pain and it has been hardwired into your nervous system and amplified.

The more those nervous system connections are used, the quicker and more sensitive they become. This is increasingly studied in endometriosis patients, but also in conditions such as irritable bowel syndrome (IBS).

This can also partly explain why pain in one area can leave us with a range of other pain symptoms. Those with IBS often have other non-gastrointestinal symptoms such as back pain, migraines, muscle pain. Those with endometriosis often have gastrointestinal symptoms, bladder symptoms, pain with sexual intercourse – regardless of where the endometrial lesions are.

Over time, these pain pathways through our nerves are strengthened, making even light touch in some folks intensely painful. These pathways can also impact other sensory pathways that are close in proximity in the body. Our nerves coming from the pelvic floor are very close to those coming from parts of the gastrointestinal system!

How do we address this?

In pelvic pain situations, we often consider pelvic floor therapy, breathing exercises, and mindfulness – alongside supplements and herbs that target the root cause and symptoms. Retraining how our body responds and connecting to how we feel can be helpful. It can also be challenging for many of us, especially if there are traumatic or painful experiences preceding the chronic pain. Pain is complex and it can take time to understand our bodies, symptoms, and responses. With proper support from practitioners, it can be transformative, safe, and effective.