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May is Pelvic Pain Awareness Month: Persistent pelvic pain information in one area

02 May, 2019

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My blog can be a useful resource for my patients (and for the general public). It’s like having a great big library of all the things I would love my patients to read at my finger tips. When we physios teach a vast amount of seemingly complex medical information in an hour to an hour and a half- its pretty certain that most adult learners will only be able to take in about 20% of what has been said during the consultation. That’s why every patient receives not only a copy of my book, but also an extensive handout plus some extra pages if there are specific tests I want them to undertake (for example- a simple corn or beetroot test to check their bowel transit time; or a handout on the causes of faecal incontinence- and if they have pelvic pain they get the normal pelvic floor dysfunction handout as well as a dedicated pain handout).

So there’s plenty of back-up reading.

Persistent pain is a big problem and I see more and more patients with sexual dysfunction caused by vaginal pain (vulvodynia, ‘vaginismis’, overactive pelvic floor muscles, post-op gynaecological surgery), endometriosis pain and generalized pelvic pain that is not resolving. I have written quite a few blogs on pain and there are some magical video blogs from Lorimer Moseley and David Butler of the NOI Group and the NSW Government which are freely available on the internet (heartfelt thanks to NOI/BIM/Lorimer/David and others) which I encourage my patients to look at after their consultation to reinforce what they have just learned.

Today I have decided to put all these blogs together in one place to make it easier to point patients to do some pre-reading prior to their first appointment. This is not compulsory though. There are many blogs within this link – you can choose to read one or all of them. (Or you can choose to read none of them and wait for the appointment).

If patients can pre-read that there is new chronic / persistent pain education to be covered prior to the appointment, then they are more likely to listen to what the physio is saying at the consultation rather than perhaps going into a state of shock when they hear those words…….

The brain decides whether you are going to have pain or not!’

Because if that piece of information is glossed over quickly, without good education, then what patients may hear is: ‘It’s all in your head’ and that is definitely not what good persistent pain education is all about.

So what I have done is list many of these different blogs/articles that I have written about pain below- read one, look at one video or eventually read them all. But it would be helpful if you could read at least something, or listen to at least one of the pain videos to get some understanding of what it is about before your first appointment.

The important thing to know is that 1 in 4 people with persistent pain will get a 50% pain reduction in their pain when pain education is included within their standard treatment. Lyrica is 1 in 6.8 patients for comparison. (1) So simply reading these blogs may give you some improvement in your pain condition.

The writing is going to get a bit stilted from here on….. but just click on the links to go directly to the blogs.

So here is my first blog ever on pain called “Persistent Pelvic Pain”

Here is the second blog called More on persistent pelvic pain”

The third blog is called “The art of conversation” and has an introduction on the placebo effect following a great show on SBS.

The fourth blog is called “Roadblocks to compliance”

The fifth link is to a one hour TED talk which Lorimer Moseley gave in Adelaide. This is very long and only look at it if you are really into reading and knowing as much as you can about pain.

The sixth link is a brilliant 5 minute video called “Understanding Pain” summarizing everything you need to understand about pain. The content in the video was a joint project between GP Access and the Hunter Integrated Pain Service in NSW.

And the seventh link is to a short video from David Butler on “The Drug Cabinet in the Brain”

The eighth link is another little gem called “Brainman stops his opioids” by Medicare Local, BIM, NSW Government Hunter District, Uni of SA, UW Medicine and NIH Pain Consortium on how to utilize pain relief without becoming reliant on opioids.

The ninth link is called ‘Sit like a Man’ and reminds us how to down-train the abdominal and pelvic floor muscles – one of our favourite Outlander characters helps us with this blog.

The tenth link is a great short video by Dave Butler on Smudging in the brain.

The eleventh link is another excellent video by Dave Butler on Thought Viruses.

The twelfth link is about the importance of good breath awareness.

The thirteenth link is a blog I wrote on managing social anxiety called Social Anxiety in Cats and Dogs.

The fourteenth link is a blog on Mindfulness in managing Anxiety.

The fifteenth link is a recent blog I wrote about the anatomy of the clitoris called “Masturbation is not a sin”.

There are also a number of excellent texts on understanding persistent pain.

I’ve mentioned Explain Pain’ by David Butler and Lorimer Moseley many times but another great patient directed book is called ‘Why Pelvic Pain Hurts’ by Adriaan Louw, Sandra Hilton and Carolyn Vandyken and of course my own books Pelvic Floor Essentials and Pelvic Floor Recovery: Physiotherapy for Gynaecological and Colorectal Repair Surgery have a chapter devoted to managing persistent pain.

So all of these blogs, links and books are designed to de-mystify persistent pain so we are no longer scared of pain, or moving, or having sex, or inserting a tampon, or whatever fears your pain is responsible for.

the lion and the daschound

Just like this daschy is not intimidated by this lion– in fact they are best friends- you too can not only learn to live with your pain, but hopefully conquer it so it becomes a part of your past. Here is a video which shows you Milo the dog and Bone Digger the lion interacting at GW Zoo, Wynnewood, Oklohoma. Bone Digger had problems walking when he was a cub and this pup was raised with him. They are now inseparable.

(1) Moseley, Butler 2017 Explain Pain Supercharged

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