Chronic pelvic pain and osteopathy
Chronic pelvic pain
Definition
Chronic pelvic pain (CPP) is a complex, persistent and often disabling condition affecting many women and men worldwide. It is characterized by localized pain in the pelvic region lasting more than six months, and is associated with significant impairment of patients' quality of life.
Chronic pelvic pain symptoms
CPP is a non-cyclical, persistent or recurrent pain in the pelvic region, which cannot be fully explained by specific pathological causes such as acute infection or cancer. It may be accompanied by urinary, digestive, sexual and musculoskeletal symptoms. Common symptoms include lower abdominal pain, discomfort during intercourse (dyspareunia), pain during urination or defecation, and increased sensitivity in the pelvic region.
Chronic pelvic pain risk factors
Risk factors for chronic pelvic pain increase when the patient :
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has a history of pelvic inflammatory disease.
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has had a difficult pregnancy or childbirth.
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has undergone abdominal surgery or radiotherapy.
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suffers from infertility.
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has a history of physical or sexual abuse.
Pathophysiology of CPP
The pathophysiology of CPP is complex and involves several mechanisms, including neuro-muscular dysfunctions, abnormalities in pain perception and psycho-emotional disturbances. One central mechanism is central sensitization, a phenomenon in which the central nervous system amplifies pain signals, making non-painful stimuli painful for these patients. People with CPP may also suffer from pelvic muscle dysfunction, visceral adhesions and myofascial restrictions, which exacerbate symptoms.
Chronic pelvic pain treatment
Management of CPP is multidisciplinary, including pharmacological treatments (analgesics, anti-inflammatories, muscle relaxants, anti-depressants), psychological interventions (such as cognitive-behavioural therapies), therapeutic education, and sometimes surgical interventions, particularly if mechanical causes such as endometriosis are identified. However, standard treatments are not always effective, and manual therapy techniques are increasingly integrated into treatment plans to relieve pain.
Osteopathy and manual therapy in the treatment of CPP
Osteopathy and manual therapy are increasingly being recognized as effective approaches to the management of CPP, with studies showing a significant reduction in pain and an improvement in patients' quality of life. Osteopathic techniques include gentle, specific manipulations of pelvic muscles, ligaments and organs, aimed at restoring mobility and reducing tension in the pelvic region.
Manual therapies, such as myofascial release, target muscle restrictions which, if persistent, can intensify pelvic pain. These techniques also promote better blood circulation and reduce inflammation.