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Pain science research shows that pain is multidimensional. It arises from biopsychosocial factors, and it impacts our lives in many ways. Each pain experience is unique and requires an individualized approach. It is important to address all the factors in order to truly manage the pain.
Bio – An injury, tight muscle, or endometrial lesion can contribute to pain. Likewise, pain can lead to muscle tension, altered breathing patterns, and changes in posture.
Psycho – There’s no denying that we feel pain more strongly when our mental health is low. Stress, depression, and anxiety will influence our pain. We also know that chronic pain impacts our mental wellbeing in a significant way.
Social – The support systems around you can either help or hinder your ability to function and manage your pain. This includes family, work, and the healthcare system. Pain can also contribute to social isolation and self-selecting out of activities.
When we break it down, the feeling of pain is the outcome of a multi-step process. First our nerves detect a signal and send it to the spinal cord and brain. Next, that signal gets compared to memories and context, and it is interpreted. If it’s determined that there is a potential threat or harm, we feel pain and the brain tells the body how to deal with the threat. This may be a fight-or-flight response with the heart racing, fast and shallow breathing, and muscles tensed and ready to react. Or it might be a freeze response like a deer in the headlights.
At Vida Health & Wellness, our physiotherapists primarily work with a bottom-up approach. They use palpation (touch), massage, stretching, and posture to influence the signal going from the body to the brain. The physiotherapists can help with muscle tension, stiff joints, sleeping positions, and more.
The occupational therapist primarily works with a top-down approach. She has many techniques available to help process and reinterpret the incoming signals, reduce the body’s response, and regain control over the situation.
This blended approach is the key to bringing down pain levels and reducing its impact on your daily life.
On your first visit, the physiotherapist will ask you questions regarding your overall health history, previous injuries, and current condition. She will assess your posture and breathing, low back, hips, and abdomen. With your consent, she will perform an internal digital exam of the pelvic floor muscles. She can assess for a prolapse at this point and identify trigger points, scarring, and muscle weakness or tension. Pelvic health physiotherapists move slowly and respectfully. An internal exam is helpful but not required.
The physiotherapist will then work with your needs and goals to develop a management plan. She will use the treatment techniques such as muscle stretching and massage, breath work, muscle relaxation, and exercise. She may recommend occupational therapy for a combined approach (see below).
Physiotherapy for pelvic pain will typically require few appointments. You can expect to attend 4-8 times with appointments spaced 1-4 weeks apart. If you have health benefits, you can submit your visits for reimbursement or we can direct bill your insurance company.
Your appointment will be tailored to meet your needs. During your first visit, you will be asked several general questions, such as what brought you in, what your goals are, a brief medical history, and whether you have attended previous treatment for your concern. You may be provided with a brief questionnaire specific to your reason for attending the appointment.
The occupational therapist will provide you with a suggested treatment approach, and a plan will be developed collaboratively with you. A brief intervention will be provided during the initial appointment and you will likely be provided with some tools or strategies to practice before your next appointment. Examples of interventions provided in the initial appointment may include emotional regulation skills, biofeedback, or ‘unhooking’ from distressing thoughts, among others.
Typical treatment approaches may include Acceptance and Commitment Therapy, Cognitive Behavioural Therapy, Accelerated Resolution Therapy, Exposure Therapy, or Behavioural Activation Therapy, however most often a combined approach is used to meet each person’s unique needs.
Duration of treatment can vary, but typically ranges from 4-10 appointments. Appointments can occur weekly or can be spread out. Appointments are one hour in duration, except for Accelerated Resolution Therapy appointments which are booked for 90 minutes.
Our pelvic health physiotherapist is trained in physical and sexual trauma and can perform assessments and treatments that you are comfortable with. There is no need to disclose any trauma history and any disclosure that you make is handled with care and respect. Please do let us know if you have triggers, no-go zones, or anything else that we can accommodate. Internal exams are helpful but not required.
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