The (pelvic) pain programme

NB The programme below is described in terms of pain related to the pelvis, but the same ideas apply for any pain.

Aim

Many people who suffer from pain related to the pelvic region have struggled with it for years. It can be constant, it can come and go, it can take different shapes and affect different parts of the body. Because there are so many different things that can cause this pain, we need to back up and look at what the root causes might be. This means an in-depth assessment and therapy process.

A key part of the process is teaching you about your body, and what you can do to manage your situation. Pain can become an Achilles heal, in other words, it can come back when you are stressed, tired, or whatever it is that triggers your pain. If you know what to do to manage it, the risk of it flaring up is much less. A central component in the therapy is thus what you do. And that means you need more understanding of your situation. This is thus more of a programme than treatment, where both therapist and client commit to the process.

The programme includes sessions with hands-on treatment, education and movement practice.

Assessment process

The first session includes an in-depth discussion about your pain experience. You will be asked questions about much more than you have probably been asked before. Often things that have happened years ago can be relevant, and not only directly related to the painful region.

The next step is the physical examination. We will look at how you move, including some simple movement tests, and then feel the tissues and structures of your legs, stomach, back, hips. This gives very valuable information about what is going on in your body.

An important component when exploring pain related to the pelvis is the internal assessment, which can be vaginal and/or rectal. However, this is voluntary. We will never do anything that you are not comfortable with. Sometimes we will wait with this part until the second visit.

Finally, we will summarise what we have found, and discuss the findings in relation to your pain, and how it might all be connected. We will end with making a plan, where we will work towards specific activities that you want to be able to do. Depending on your situation, we might also do a test-treatment.

We will have an idea of what is going on at the end of the assessment, but it is not until we start the treatment that we really can start understanding what is going on. How you respond to the therapy tells us much about your situation.

Treatment process

The treatment will depend on what we find in the assessment. It almost always involves hands-on myofascial/fascial/visceral therapy which is an important part of breaking the cycle of pain (this might include internal treatment). We will go through the model for pelvic pain, to help give an overview of all the different components of your pain, and and understanding of what issues might be the key ones to focus on. You will be taught breathing and relaxation exercises, healthy pelvic habits, simple movements to do throughout the day, as well as self-assessment and treatment. It might also be relevant to look at seeking other professionals help, depending on what we find in the assessment.

We will meet usually once every 1-2 weeks to start with, and then we spread the sessions out as you improve and as you get more confident treating yourself. The key point is that your participation is the most important part of the process. What will have most impact on your pain is what you do in the time you are not in the clinic.

Preparing for the visit

Please visit your doctor or gynaecologist before booking an appointment. If you haven’t done this when you come for the assessment, you will be asked to do this before we proceed with treatment. The reason for this is that we want to eliminate any other possible causes of the pain that require medical attention.

Sometimes it can be helpful to write down specific questions or concerns that you have before hand. We will address those before we start.

Bring any reports or test results from previous assessments/treatment.

It is best to come after you have had your period, not during or immediately before.

If you have the flu or are ill, please re-book your appointment. We cannot do any manual work if you are unwell.

I look forward to meeting you in the clinic, and starting this journey with you!

Jenny Wickford