Central Sensitization is a pathophysiological process in which the central nervous system undergoes changes that alter pain processing leading to hypersensitivity. Central Sensitization occurs with Chronic Pelvic Pain and Endometriosis.
Central sensitization corresponds to an enhancement in the functional status of neurons and circuits in nociceptive pathways throughout the neuraxis caused by increases in membrane excitability, synaptic efficacy, or reduced inhibition. In short, it means that central sensitization intensifies the pain felt in the body.
While there are no specific symptoms relating to central sensitization, patients typically experience chronic, widespread pain that gradually becomes more severe over time.
Central sensitization occurs secondary to a chronic pain state. Common underlying conditions are seen in Central Sensitization in the setting of Pelvic Pain.
Endometriosis
Bladder Pain Syndrome/Interstitial Cystitis
Pelvic Floor Hypertonia
Chronic Pelvic Pain Syndrome
Underlying chronic injury
Neuroinflammation
Psychological factors
Some people with central sensitization also have preexisting health conditions that may increase the risk of them experiencing the pain of central sensitization syndrome.
Having a chronic pain condition, such as arthritis
Family history
Previous serious injury or infection
Having an autoimmune condition, such as lupus or multiple sclerosis
Patients with chronic pelvic pain conditions such as endometriosis
Diagnosing central sensitization in the setting of pelvic pain requires an in-depth examination of both the central and peripheral nerves evaluating the muscles within the pelvis, learning of your medical history, and getting a full picture of your symptoms and lifestyle.
Here’s what you can expect when you are a patient at Pelvic Rehabilitation Medicine:
Step One – First, our providers will ask questions about your medical history and listen to your symptoms to get a full picture of what is going on with you.
Step Two – Next, an external exam of your hips, abdomen, and posterior sacrum.
Step Three – Next, your pelvic nerves are evaluated externally with a soft cotton tip.
Step Four – Next, with your consent, gel is placed on a gloved finger and an internal exam is performed to allow us to evaluate the nerves and muscles within the pelvis. There is no speculum required as we are evaluating the pelvic floor muscles and nerves not the organs.
Step Five – Sometimes patients will need Imaging to help us understand if there is an associated cause of the pelvic nerve and muscle pain and dysfunction found on exam.
Step Six – Oftentimes, treatment can be started the same day as there is no down time. Our patients have been suffering with pelvic pain symptoms for 6+ months. We like to get them on the road to feeling better as soon as we can as the longer the symptoms are present the harder it is for us to resolve them.
Once a proper diagnosis has been given, we offer a proprietary office-based procedure to treat pelvic floor dysfunction and pelvic pain caused by central sensitization. This treatment consists of a series of pelvic nerve and muscle treatments to directly target the spastic pelvic floor muscles, inflammation in the pelvis, and nerve pain. Depending on the severity of your central sensitization syndrome, other modalities may be needed in addition to our treatment.
Experiencing the symptoms from central sensitization can be debilitating and discouraging, but our team of pelvic pain specialists will listen to you, validate your experiences and symptoms, and partner with you on your rehabilitation journey.
While central sensitization is considered a syndrome and not a diagnosis, the symptoms can hinder your ability to perform everyday tasks at home, work, and participate in your social life.
We recommend scheduling an appointment with one of our pelvic pain specialists if you have been experiencing pelvic pain or pelvic floor dysfunction in correlation with central sensitization for 6 months or longer.
With the PRM Protocol, PN patients can experience increased pelvic function and decreased pain.
After the PRM Protocol, 88% of patients stated they missed 0 days of work due to their pelvic pain in the last 3 months.
After the PRM Protocol, 75% of patients stated their pelvic pain symptoms affected them 0 Hours per week while at work.
After the PRM Protocol, 96% of patients did not need to go to the ER for their pelvic pain in the past 3 months.
75% of our patients note a statistically significant improvement in pain and function.
You’ll meet with one of our pelvic pain specialists, who focuses solely on pelvic pain. We’ll start by reviewing your full health history, including a discussion of your symptoms. This will help us to understand what you’ve been experiencing, so we can work to identify the source of your pain.
Next, we’ll conduct a full pelvic exam. Externally, we will look at your hips, abdomen, and posterior sacrum. Internally, we will evaluate the nerves and the muscles within the pelvic area. This full exam is necessary, as it will help our pelvic pain specialists understand the connection between your symptoms, and your nerve and muscle pain and dysfunction. There is no speculum, so the exam is gentle and more comfortable than that of, for example, gynecological exams you may have experienced in the past.
We will discuss our findings with you and come up with a comprehensive treatment plan TOGETHER. We want you to know that your pain is validated and that we are here to work with you on getting you back to the life you deserve.