Endo, Chronic Pelvic Pain, and Central Sensitization
As a health journalist, I sometimes reap the benefits of being alerted to new or interesting theories or studies about endo and other health disorders I have, often before it becomes common knowledge. As such, I try to do my best to spread the news or awareness about new findings or research as quickly as I can so that other people with the similar/same diagnosis can also benefit.
New research on endo & chronic pain
Very recently, I interviewed a psychologist who has been doing more research recently into endometriosis. In particular, she's been investigating the role endometriosis may be not just in more generalized chronic pelvic pain, or CPP (that which occurs independently of one's period), but also in Central Sensitization.
What is Central Sensitization?
According to Institute for Chronic Pain, "Central Sensitization" refers to a process under which the nervous system, due to prolonged pain, rewires itself to become extra sensitive to pain signals and amplify them. In fact, it may actually cause sensations that wouldn't ordinarily be considered painful to be interpreted by the nervous system as painful. (For instance, a light touch could be painful for someone with central sensitization).
Past studies have found a correlation between Central Sensitization and general CPP (that is, CPP not specifically associated with endo). The study found that in endo-related CPP, hypersensitivity not just sustained but "amplified by an extensive central neural network" in the abdominal cavity and can actually result in neuropathic pain.1 The study also mentioned that Central Sensitization can actually contribute to changes that increase pain signals to the spinal cord and lead to referred pain in adjacent areas- like the abdominal cavity.1
The importance of early treatment and detection
But what does this mean? Well, it indicates that the longer endo and its associated pain is left untreated, the more likely it will evolve to become severe chronic pelvic pain that occurs all month and will even endure after endometrial lesions are removed. So, if endo is detected and treated earlier, before the acute pain can become chronic, it may prevent CPP. Also, if CPP does develop, it means treating CPP and Central Sensitization through modalities like pelvic floor therapy, and other types of physical therapy meant to retrain the nervous system to dampen pain signals. Treatment may also necessitate cognitive behavioral therapy that can treat the depression, anxiety, and catastrophizing that usually accompanies chronic pain. Together, these treatments can actually work together to help reduce or eliminate endo-associated pain.
Hope for the future
While it may not be a cure (because nothing is yet), it can be a holistic treatment with better outcomes than just surgery and hormones. I, for one, am excited about these new findings and what may come out of it with further research. It also makes sense when I consider how many women still had such bad pelvic pain after their laps and even after hysterectomies, yet their pain improved after more thorough physical therapies that target chronic pelvic pain and central sensitization.
Have you had any luck with holistic treatment options for chronic pelvic pain with endo? Please share in the comments below!
Have you had any of the following surgeries for your endo?