Pelvic pain conditions such as endometriosis, adenomyosis and bladder pain syndrome are complex conditions to manage and have a significant impact on quality of life. Remedial massage can be a helpful tool in the management of these conditions.
Conditions that cause pelvic pain are different to other pain conditions because they are more likely to contribute to sensitisation of the nervous system, both centrally (brain/spinal cord) and locally (local nerve fibres). The brain is particularly protective of pain in the pelvic area and will respond accordingly! Central nervous system sensitivity causes a reduction in the threshold needed to produce pain signals. As a result, people with pelvic pain will tend to experience more pain.
Stress will also exacerbate a person’s experience of pain. Interestingly, poor sleep can also worsen how a person experiences pain. People often accept, if I am in pain I cannot sleep, but the reverse is also true, if you cannot sleep this can also cause pain.
Chronic pelvic pain tends to cause the muscles around the pelvis to increase in tension. This occurs subconsciously as the body makes an attempt at bracing itself to protect the organs below. However, over time these tense muscles become tired and sore. Imagine if you were carrying around a dumbbell in your hand all day, your arm would become sore and very tired. This is what happens to the muscles around the pelvis in people with pelvic pain and most people do not realise. It may have been building up over many years. This is adding pain to your experience in addition to the initial disease process. Stress may also have a similar effect on the muscles around the pelvis, they will contract and increase in tension. Many people may be aware of clenching their jaw when they are stressed but don’t notice the muscles supporting the abdomen and pelvis are tense as well.Â
Digestive disturbances are common in pelvic pain conditions. This may include issues with diarrhoea, constipation or a mixture of both. This can be due to many causes including irritation from inflammation around the gut, pain relief medication, hormonal imbalance and the effect of stress on the gut. Constipation and diarrhea will add additional pain and discomfort so need to be addressed.
How remedial massage can help:
- Remedial massage aims to facilitate relaxation in muscles with increased tension and reduce the overall pain picture. Muscles that commonly have increased tension in pelvic pain conditions include the abdominals and hip flexors. However, each person is assessed individually and treated according to their assessment. I use gentle manual techniques as well as active stretches with facilitated relaxation. You will also be taught exercises to self-manage at home.
- I use relaxation techniques to down regulate the nervous system to calm central and local pain signals, as well as improve sleep quality and calm increased gut motility.
- Remedial massage can improve gut motility through manual techniques on the abdomen. I may also use a gentle technique called visceral manipulation to address specific areas of adhesions in the connective tissue of the abdominal organs. You will also be taught self-management strategies to continue at home.
Important considerations:
- Remedial massage for pelvic pain conditions should not be painful. Generally, we would work to a maximum level of 4/10 on a pain scale (if ranking 10 equals worst pain and 0 is no pain). If the massage is painful the muscles will continue to brace and not effectively relax and your nervous system will remain heightened. Pelvic pain conditions may also be easily flared so extreme care is taken to see how each person responds.
Remedial massage cannot change the initial diagnosis but can help address these other factors which may be exacerbating the pain. Chronic pelvic pain conditions are always best managed with a multidisciplinary team to ensure the person is fully supported and all aspects of the disease are being managed.
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If you have any questions for Heather before booking, please email our reception team at info@elementalhealth.net.au.