Self- management describes ways of looking after your pain without the need of a health care professional, medications or surgery. This can empower you to be proactive and engaged in your care between appointments and medical interventions.
The ideas that are discussed in this article will help to focus on developing positive, problem focussed coping strategies for managing chronic pelvic pain.
It may be valuable to keep a diary to see what works for you.
Strategy #1 - Education and social wellbeing
You may want to understand more about the condition which is causing your pain.
Some people find this helpful to then manage symptoms. There is a lot of information online, but not all is evidence-based (based on research results that have been reviewed for their quality). Good sources are Endometriosis UK (endometriosis-uk.org/), and the pelvic pain support network (pelvicpain.org.uk).
It may also be helpful to understand a body response called “pain memory” which is thought to be one of the reasons why chronic pain occurs.
When the body experiences pain, we think that the nervous system creates a “memory” of the feeling. This means that in the future, the nerves are very sensitive to any sensation, which in turn can increase the feeling of pain for that person. Often the feeling/pain is much stronger/long lasting than in someone who doesn’t have the pain “memory”. It also means that you may feel pain from a sensation that someone without the memory would not.
As far as social wellbeing is concerned, it may be helpful to schedule social activities at times when you are less likely to be experiencing a flare of pain.
Try as much as you can to carry on with social activities within the rules of social distancing/isolation. It is possible to “attend” many experiences online/virtually now e.g., arts and culture organisations. To look at the positive side, this may be an opportunity to look at different ways to connect socially, which for women dealing with chronic pain could be useful in helping reduce social isolation now and in the future.
Strategy #2 - Exercise & physical coping strategies
Exercise is a very individual thing and you will need to judge what type and intensity of exercise is appropriate for you. Explore different types of exercise to find the ones you like! We suggest making sure that you always use a graduated/step-wise approach to whatever exercise you choose, and set goals which are achievable and sustainable. Small goals such as building daily step totals by 100 steps are achievable and sustainable. Some people find it helpful to walk/exercise to music/podcasts/education/audio-books or with a buddy.
Yoga has been shown to be helpful in reducing chronic pelvic pain and improving quality of life in women with endometriosis, as well as pain where there is not a clear diagnosis.
We recommend using instructors/poses especially geared towards managing endometriosis/pelvic pain as certain poses are not recommended. Remember to listen to your body and try to know when it’s too much. It’s better to try little and often rather than go in hard, feel pain and then not want to try again.
Pelvic floor exercises/relaxation and breathing exercises can support your healing process. Try the “simple pelvic exercise programme” from “Endometriosis UK”.
Tens Unit: A tens unit sends electrical pulses through the skin and helps your body to release endorphins which are its own natural painkillers.
In women with persistent pelvic pain these electrical signals help to block and replace the painful signals being sent to your brain. A TENS unit can be bought in any pharmacy.
To use a Tens unit, stick 2 of the pads at the same level on your lower tummy or low/mid back (whichever works best for you). A pad on the lower central tummy may help with bladder pain. Make sure pads are stuck down well and not peeling off.
You could consider applying heat packs at a stable temperature (38 degrees) to help manage pain symptoms. Some suggest adhesive patches but deep heat creams can also be really useful!
Mix it Up! Different things work well for different people, don't be afraid to try things out!
Strategy #3 - Emotional wellbeing
We know that sleeping helps us to cope better with physical and psychological symptoms that are common in women who suffer from chronic pain. Problems with sleep often go hand in hand with increased symptom severity and worsening quality of life.
Try to get 7-9 hours of sleep per night. It may help to remove things that can cause problems such as noise that can be stopped, light, distractions in bed (e.g., smartphones and other electronics). Avoiding caffeine after lunch is also advisable to help ensure good quality sleep.
If working from home in your bedroom, it could be valuable to have a routine of “switch-off” 2-3 hours before you sleep.
Mindfulness, progressive muscle relaxation and breathing exercises can all help
with chronic pain symptoms. Some people relax listening to music/ relaxation tracks/ religious content.
Strategy #4 - Dieting adjustments
The FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) Diet may help to reduce certain symptoms such as bloating that are troublesome to many women with chronic pelvic pain. This involves cutting out different food groups one at a time.
Dairy: Milk (cow/goat/sheep), yoghurt, soft cheese
Pulses: Beans, lentils, dhal, hummus/chickpeas
Gluten/Wheat: Bread, pasta, cous-cous, biscuits, but not in “free from” food
The above are just examples of the groups and there is a more detailed list of foods on the references at the end of this leaflet.
By removing one group at a time, it is easy to identify if there is an improvement. If there is no change with stopping eating one group of foods, they are unlikely to be increasing your symptoms and so you can consider eating them again. Make sure you still eat a rounded diet, such as replacing milk with plant-based milk.
If you suffer with pelvic pain it is important to try to avoid constipation by having a good amount of fluids and fibre (such as ispaghula/psyllium husk and linseed).
It can also help to keep a diet, bowel-movement, symptom diary to identify the food items causing symptoms. If you have a rounded diet it is not necessary to take supplements,
unless you are deficient (Iron/Vitamin D).
Helpful links for you:
The app flare can help you keep a diary: https://flaredown.com/
The following links to Yin yoga: http://yogayin.com/endometriosis-yoga/
For sleep and ways to improve this, search for www.sleepfoundation.org/
"The post on mindfulness and relaxation techniques was incredibly helpful. Practicing deep breathing and meditation has significantly reduced my stress levels and pelvic pain." For more info visit our official website https://www.hopefertilitypreservation.in/ or contact us @ +91 98453 31194