I had the pleasure of attending Dr. Kenneth Peters’ lecture on the role of the Peripheral Nervous System (PNS) in the development and management of pelvic pain. Kenneth Peters, MD is a urologist practicing at Beaumont Hospital in Royal Oaks, MI, who specializes in treating complex pelvic pain including interstitial cystitis. For more information on Dr. Peters, check out his website here.
Many patients find that managing chronic pelvic pain conditions can sometimes be difficult. Oftentimes there is no one “thing” or pathology that symptoms can be tied to which, understandingly, can be frustrating or overwhelming. More accurately, chronic pelvic pain is a complex interaction of both physiological and psychosocial components. It is not only the body but the mind and the environment that can contribute to a pain experience.
While attending the 3rd World Congress on Abdominal and Pelvic Pain organized by the International Pelvic Pain Society, I had the privilege of listening to Rhonda K. Kotarinos, DPT, MS give a lecture on the topic of urologic chronic pelvic pain and manual physical therapy. Rhonda K. Kotarinos, DPT, MS is a Doctor of Physical Therapy practicing at Kotarinos Physical Therapy, where she treats women and men experiencing pelvic floor dysfunction. Her aim in this lecture was to discuss manual physical therapy treatments for urological chronic pelvic pain syndromes, including research, treatment guidelines, and defining/explaining the manual physical therapy techniques of trigger point release, connective tissue manipulation, and neural mobilization and stretching.
Understanding and effectively treating chronic pain continues to challenge the medical community. Now more than ever, there is a sense of urgency to treat this disease. With the astounding reports of opiate addiction and opiate related deaths in this country, we now know that throwing drugs at chronic pain is not the answer. So what is the answer? Thankfully there is a lot of ongoing research trying to figure that out. At the 3rd World Congress of Abdominal and Pelvic Pain in October 2017, some exciting research about chronic pelvic pain was presented which we will share here in the 3rd post of our blog series covering the conference.
This year at the annual meeting of the International Pelvic Pain Society (IPPS) and the 3rd World Congress on Abdominal and Pelvic Pain (WCAPP), Endometriosis expert Dr. Katy Vincent spoke about why we should not only look at endometrial lesions alone in pain generation (a purely peripheral model), the evidence of central changes in association with endometriosis, and to consider the comorbidities of endometriosis and how it changes clinical practice. In this blog, I will do my best to summarize the complex information from her lecture and help our patients understand what this information mean for them.