A Nightmare for Both Women and Men: A New Era in Treatment
The causes of CPP are highly varied and usually arise from a combination of multiple factors. In this article, we will explain the causes of CPP in a simple way and focus on the role of neural therapy and manual medicine in treating this pain.
The Underlying Causes of Chronic Pelvic Pain We can group the underlying causes of CPP under a few headings:
- Anatomical Structures of the Pelvic Region: The pelvic region contains many muscles, joints, and nerves. Disorders occurring in any of these structures can cause pain. For example, weakness of the pelvic floor muscles or inflammation in the pelvic joints are common sources of pain.
- Relationships with the Nervous System: Overstimulation or compression of the nerves in the pelvic region can lead to CPP. Irregular functioning of the nerves in this area can cause pain signals to be constantly transmitted to the brain.
- Musculoskeletal System Problems: Problems in the connections between the spine and the pelvic region are also among the causes of CPP. A disorder occurring in the spine or muscles can cause pain that radiates to the pelvic region.
- Psychological and Social Factors: Psychological problems such as stress, anxiety, and depression can contribute to the emergence or worsening of CPP. Similarly, social isolation and life stress can also increase pain.
Myofascial Trigger Points and Pelvic Pain: Compared to other regions of the body, the pelvic region houses many muscle and ligament structures, and the risk of active trigger points forming in this region is quite high. Trigger points are usually hard and sensitive points that occur when tension and spasm develop in the muscles. These points develop as a result of chronic overuse of muscles and surrounding tissue, or exposure to trauma.
The Relationship Between Trigger Points, Commonly Known as "Kulunç," and Inflammation: The formation of trigger points is generally associated with localized inflammation resulting from microtrauma or continuous stress. Although inflammation speeds up the healing process by increasing blood supply to tissues, continuous and chronic inflammation can cause permanent damage to muscles and lead trigger points to become chronic. During the inflammatory process, chemical changes occurring in muscle tissue lead to increased tension and sensitivity in muscle fibers, causing trigger points to become even more active. These trigger points hinder the normal function of muscle tissue, reduce muscle flexibility and strength, and become a constant source of pain in the pelvic region.
Biophysical Diagnosis in CPP: Biophysical diagnosis is important in determining the organic and functional disorders underlying CPP. This method evaluates the condition of the musculoskeletal system, nerve network, vascular structures, and connective tissue in the pelvic region. Biophysical evaluations can include:
- Electromyography (EMG): Measures the electrical activity of the pelvic floor muscles.
- Pelvic ultrasonography: Images the anatomical structure of pelvic organs and tissues.
- Magnetic resonance imaging (MRI): Provides detailed imaging of soft tissues.
- Neural therapy: Used for regulating the nervous system, it can be effective in identifying neural disorders causing pain.
Biophysical and Biomechanical Causes in CPP: The biophysical and biomechanical causes of CPP include:
- Pelvic floor dysfunction: Excessive tension or weakness of the pelvic floor muscles can cause pain.
- Musculoskeletal system disorders: Dysfunction of the pelvic bones, joints, or muscles can lead to pain.
- Neuropathic pain: Nerve compression or damage can contribute to CPP.
- Vascular causes: Blockages or varicose veins in the blood vessels of the pelvic region can cause pain.
- Fascia and connective tissue problems: Structural disorders of connective tissue can also contribute to chronic pain.
Neural Therapy and Manual Medicine: Neural therapy and manual medicine are considered effective methods in treating chronic pelvic pain. While neural therapy specifically targets regulation of the nervous system, manual medicine focuses on correcting tension and dysfunction in the musculoskeletal system. Ligamentous structures are frequently taken into account in these approaches and carry particular importance during treatment.
Neural Therapy in the Treatment of Chronic Pelvic Pain: There are many methods used in the treatment of chronic pelvic pain. One of these methods is neural therapy, another is manual medicine; neural therapy relieves pain especially by helping regulate the nervous system. So, how does neural therapy work?
Neural therapy is applied by injecting local anesthetics into specific areas of the body. These anesthetics help reduce pain by preventing the overstimulation of nerves. This method, which is particularly effective on nerves in the pelvic region, aims to break the pain cycle by targeting the source of the pain. Neural therapy regulates the electrical balance of nerve cells, stopping the transmission of pain signals and thereby causing the pain to ease.
Neural therapy is a treatment method that targets regulation of the nervous system in the treatment of chronic pelvic pain. This approach is particularly effective on the autonomic nervous system, aiming to correct neural communication networks. The mechanism of action of neural therapy is based on rebalancing disrupted cellular electrical potential and reducing pain through regulation of the neurovegetative system. During application, local anesthetic injections are given to target areas such as nerves, ganglia, muscle tissue, and trigger points. These injections relieve pain by reducing inflammation in the area and preventing overstimulation of nerves. In addition, local anesthetics block sodium channels in the cell membrane, temporarily stopping nerve conduction and allowing nerve cells to return to normal function. In this way, the chronic pain cycle is broken, and patients experience a reduction in pain, or even its complete disappearance.
Used as the primary tools of neural therapy, they help eliminate irregularities in the nervous system and relieve chronic pain. Both lidocaine and procaine provide neural regulation while also contributing to correcting inflammation and circulatory disorders. For this reason, neural therapy is recognized as an effective approach in the treatment of chronic pelvic pain.
Conclusion: Chronic Pelvic Pain is a complex clinical condition that can develop due to a wide variety of causes. In this article, the anatomical, physiological, and neural foundations of pelvic pain have been addressed, and the relationship between trigger points and inflammation has been detailed. It has been shown that methods such as neural therapy, manual medicine, and osteopathy are effective treatment approaches. A multidisciplinary approach in the treatment of pelvic pain is critically important both for relieving symptoms and for improving patients' quality of life.
Chronic pelvic pain is a complex condition, and understanding biophysical and biomechanical factors is critically important in the diagnostic and treatment process. With a multidisciplinary approach, a meaningful improvement can be achieved in the quality of life of these patients.
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