May Is Pelvic Pain Awareness Month!

Mayis PelvicPainAwarenessmonth

 Kaitlyn Parrotte, PT, DPT, OCS, CFMT

While there are many causes to be aware of and advocate for, one close to our hearts at Beyond Basics Physical Therapy is pelvic and abdominal pain, and we are excited to report that May is Pelvic Pain Awareness Month! This designation for May was created by the International Pelvic Pain Society last year. So let’s talk a few moments about what is abdomino-pelvic pain, how impactful the diagnosis can be, and what we can do!

According to the American College of Obstetricians and Gynecologists, chronic pelvic pain is described as a “noncyclical pain of at least 6 months’ duration that appears in locations such as the pelvis, anterior abdominal wall, lower back, or buttocks, and that is serious enough to cause disability or lead to medical care.”(1) While the incidence and prevalence of chronic pelvic pain in men and women are reported in an inconsistent manner,(2) some estimates compare its global prevalence to asthma (4.3%-8.6%), and another to the prevalence of low back pain (23.2 +/- 2.9%).3 Individuals who suffer from chronic pelvic pain also often present with other complicating factors such as depression, anxiety, poor sleep, difficulty with work, and/or relationship issues. Also, many people with chronic pain are commonly disabled by fear that activity will make things worse.(2) Furthermore, pelvic pain is puzzling as it is a multisystem disorder, which includes sexual, bowel, urinary, gynecological, and musculoskeletal symptoms. It is challenging to determine a clear mechanism of pain with this diagnosis, and the term “pelvic pain” does not take into account the many signs and symptoms that may be occurring outside of the anatomical pelvis.(2 ) 

Due to the complicated nature of this condition, there is a significant economic burden associated with management of it. In the United States, approximately $881.5 million was spent on chronic pelvic pain to cover the costs of direct healthcare. Additionally, approximately $2 billion was spent as an overall cost, which includes direct medical costs and indirect costs, such as those related to absenteeism from work.(3) Besides economic burdens on individuals suffering from chronic pelvic pain, there are also many challenges for the healthcare system to deal with. For instance, while a diagnosis of chronic pain in the United States typically yields more than 80% of physician referrals, it is estimated that only about 15% of individuals with chronic pelvic pain consult primary care providers, and only 40% of this group are referred to specialists for further investigation. (3) Furthermore, if specialist care is involved in the management of chronic pelvic pain, it is often spread between multiple specialties, such as urology, gynecology, urogynecology, colorectal services, pain medicine, and even occasionally spinal services, rheumatology, and neurology. Thus, there is a risk that patients may be passed back and forth between different teams of the same specialty, or between different specialties, and may not receive consistent or effective care.(2)  In a nutshell: chronic pelvic pain can be a debilitating condition that can have significant consequences on an individual’s physical, mental, economic, and social well-being.

Hopefully, if you were not already passionate about raising awareness of pelvic pain, you now have some insight as to why this cause is so important! Now the question lies, what can you do? How can you get involved?

Please consider visiting the website for the International Pelvic Pain Society (www.pelvicpain.org) and donating funds for educational and research programs. Together, we can help bring chronic abdominal and pelvic pain into the forefront of healthcare, to ensure individuals dealing with this condition are receiving consistent and effective multidisciplinary care.

 

Sources:

  1. Andrews J, Yunker A, Reynolds WS, Likis FE, et al. Noncyclic chronic pelvic pain therapies for women: comparative effectiveness. AHRQ Comparative Effectiveness Reviews, Rockville (MD), 2012.
  2. Baranowski AP, Lee J, Price C, Hughes J. Pelvic pain: a pathway for care developed for both men and women by the British Pain Society. Br J Anaesth. 2014;112(3):452–9.  
  3. Ahangari A. Prevalence of chronic pelvic pain among women: an updated review. Pain Physician. 2014;17(2):E141–7.

May is Pelvic Pain Awareness Month

Mayis PelvicPainAwarenessmonth

Fiona McMahon PT, DPT

May is Pelvic Pain Awareness Month: #PelvicPainAware. This is a big deal to us at Beyond Basics Physical Therapy, where we see it as our mission to spread awareness of pelvic pain and dysfunction to clinicians and patients alike. This month is spearheaded by the International Pelvic Pain Society (IPPS), of which, the founder of Beyond Basics, Amy Stein is the president. Amy took time to sit down with me to describe all of the fantastic things that are planned for this month so I can share them with you.

Before we get started, I want to share a little about IPPS, the organizer of Pelvic Pain Awareness Month. IPPS was founded in 1996. It is a society of healthcare clinicians who treat abdomino-pelvic pain conditions in men, women, and children. Their mission is twofold: “To educate healthcare professionals how to diagnose and manage chronic pelvic pain, thereby changing the lives of patients worldwide.” and “To bring hope to men and women who suffer from chronic pelvic pain by significantly raising public awareness and impacting individual lives.” Pelvic Pain Awareness month, is our opportunity to spread awareness among professionals and public alike in hopes of improving outcomes and demystifying pelvic pain.

Now let’s get started with Amy’s interview!

Fiona: Why did IPPS feel the need to start a pelvic pain awareness month?

  • Amy: I felt like it was needed. As president of IPPS, I wanted to make some changes to awareness, and I felt this was a great opportunity to get the word out and stop patients from having to suffer in silence. I wanted it to be abdomino-pelvic pain awareness month, but the phrase was too long.

 

Fiona: What activities does IPPS have planned this month to spread awareness of pelvic pain?

  • Amy: We created a pelvic pain awareness page on facebook and continue to tweet about it @intpelvicpain. We are also doing a blog talk radio interview with Lorimer Moseley, PhD, PT from Adelaide, Australia, on blogtalk radio/pelvic messenger on Thursday, May 18th at 7.30pm EST. Lorimer Moseley has written 270 articles and 6 books on pain. If you want to interview someone who is experienced in the study of pain and the brain, he is a good person to be interviewing. May 17th in New York City, we are doing a local fundraising/ networking event in the Green Room on 23rd street from 6:30-8:30pm to create more awareness locally. On may 25th, 9pm EST, 6pm PST we are doing a twitter journal club. An article on sexual health in women affected by cancer  will be featured, as well as one on vulvodynia, and prostatitis . [Click here to access the articles we will be discussing!] Each year we plan to add on more events for May is #PelvicPainAware both locally and internationally. 

 

 

Fiona: Why is it so important to build awareness of abdomino-pelvic pain conditions? What was the big driver for IPPS in doing this work?

  • Amy: Bringing awareness of abdomino-pelvic pain conditions is one of the main missions for IPPS, as well as Beyond Basics Physical Therapy and I believe it is a mission of many of other clinics, hospitals, etc, that treat pelvic pain. Again, it is such a common experience of many, many patients who visit us, to have gone to various well-known institutions throughout the country for pelvic pain, to be told it is all in there head and that they just need mental health therapy or a glass of wine. This infuriates me STILL (20 years later!), as well as the patients. Often times it will take just one session with an experienced pelvic health physical therapist or healthcare provider to have hope again. Many of our patients have been to 5 up to 10 physicians/healthcare providers and ended up being misdiagnosed, undiagnosed, or told to go home and relax; or even worse, have more sex or switch partners. Yes, pain is processed in your brain, but there is a physical component with most of these patients.

Fiona: Where would you suggest someone who is starting their journey? What resources would you recommend?

  • Amy: I would suggest to look at International Pelvic Pain Society, International Cystitis Association, IC-network, Endometriosis Association, National Vulvodynia Association, American Physical Therapy Association (APTA) or Herman and Wallace “ Find a provider”, for you to find physical therapists and physicians. Even taking that a step further, when you find a provider, do some research: ask how often your provider sees pelvic pain patients,, how long have they been treating in this area, because that can make a difference. If you go to someone who is not as experienced or is not trained, you might hit a roadblock or plateau in your progress.
  •  I would caution against looking up too much on patient-centered forums; however, here are a lot of great blogs out there that can help give you helpful information. There are some great books out there, like Heal Pelvic Pain, and Pelvic Pain Explained, Sex without Pain, and Pelvic Pain Management.  For providers, I want to add that IPPS is hosting the World Congress on Pelvic and Abdominal Pain in Washington D.C. at the Renaissance Hotel in October 11-15th. We have Lorimer Moseley and Paul Hodges flying in from Australia. They both have done extensive research in pain. This year we are doing 9 clusters on different topics with poster and abstract presentations, as well as a post conference on The Pain Revolution, with Paul Hodges, PhD and Lorimer Moseley, PhD, PT

Fiona: If you had to distill your message for May is Pelvic Pain Awareness month, what would you like the public, people with and without pelvic pain to get from this month?

  • Amy: I would like them to know there are resources and providers out there for abdomino-pelvic pain conditions. But remember to do your homework when deciding who and what is best for you. For providers, there are great resources too, including the International Pelvic Pain Society to help better your practice.

We also want everyone to know we are having a give away in honor of Pelvic Pain Awareness Month! Learn more info below!

For Everyone!

IPPS Facebook Page

Twitter: @IntPelvicPain #pelvicpainaware

IPPS

Blog Talk Radio/Pelvic Messenger

 

For Patients!

International Pelvic Pain Society: Find a provider

National Vulvodynia Association: Health Care Provider List

APTA Find a clinician

Herman and Wallace Find a Clinician

 

Give Away Information

Giveaway open internationally ). Must provide a mailing address within 48 hours of notification of winning, otherwise another winner will be selected at random. Click here for full details,
We have several generous donors lined up for the hour and will be randomly giving away the following items during the event:
1 Copy of Amy Stein’s Book “Heal Pelvic Pain” & DVD Healing Pelvic and Abdominal Pain”  (follow @beyondbasicspt @HealPelvicPain2)  (Open to International)
1 Copy of Heather Jeffcoat’s book “Sex Without Pain: A Self Treatment Guid to the Sex Life You Deserve” (follow @SexWithoutPain @TheLadyPartsPT) (Open to International)
1 Copy of Stephanie Prendergast and Elizabeth Rummer’s book “Pelvic Pain Explained”   (follow @PelvicPainExp @PelvicHealth) (Open to International)
1 Gift Card to Soul Source Dilators (link to soulsource.com)  (follow @SoulSourceTD) (Open to US only)
2 EndoFemm heating/cooling pads by Pelvic Pain Solutions (Open to US only)
2 CAPPS Travel Cushions by Pelvic Pain Solutions by Pelvic Pain Solutions  (follow @EndoFEMM) (Open to US only)
2 Multi-Comfort Therapy Pads by Pelvic Pain Solutions (Open to US only)
Official Rules: This giveaway is open to US only (except where specifically indicated as international above). The following guidelines must be followed to be eligible: Use the #PelvicPainAware hashtag during the twitter party from 6PM PST to 7PM PST to be entered into the random drawing. Must follow @IntPelvicPain @TheLadyPartsPT so we may contact you after the event regarding your winnings. Winners will have 48 hours from the time of notification to provide us with their eligible mailing address, or else a new winner will be randomly selected.
 
Twitter Party/Journal Club Disclaimer: Tweets during the 1 hour event are not to be taken as medical advice. We recommend following up with your team of providers to gain your most optimal care.

 

PH101: Pain and Sexuality: Is it all in my head?

cute-couple-with-umbrella-in-blossom-field-web-header

By Fiona McMahon, DPT

Sex should feel good… really, really good. But when it doesn’t, you may start to wonder, what’s wrong with me? Am I broken? Am I a prude? Am I frigid? Painful sex isn’t something we talk about. No one would look at you twice if you walked into work complaining of pain in your elbow, but if you walk into work complaining about pain in you vagina or penis, you may end up having a meeting with HR.

On October 6th at 7pm, we at Beyond Basics are breaking down those taboos and having an educational seminar, followed by an optional question and answer session at the end. We will discuss the many causes of sexual pain and how physical therapy can help.  The event will be hosted by one of our therapists, Stephanie Stamas, DPT, ATC. Stephanie will give a detailed seminar about pelvic health and take time to clear up some common misconceptions many people have concerning their bodies and sexual function.

Please join us at our office at:

110 East 42nd Street, Suite 1504

New York, NY 10017
Register at: pelvichealth-101.eventbrite.com

Here is our line up of this and future classes

Pelvic Health 101 Fall- (003)

Amy is Live with Integrated Pelvic Health!

Fiona McMahon DPT

amy2016What would you ask a pelvic floor physical therapy expert about exercise, or about the pelvic health as an athlete, if you had the chance? Don’t miss Amy Stein, founder of Beyond Basics Physical Therapy and author of Heal Pelvic Pain answer some commonly asked questions in a webinar hosted by well-renowned Jessica Drummond of Integrated Women’s Health Institute. Jessica is a nutritionist specializing in abdomino-pelvic health and dysfunction.  She will be interviewing Amy on the athlete and pelvic floor dysfunction, treatment paradigms, and practical tips for relieving the under active and the overactive pelvic floor.

Details:

Time: Friday, Sept 23, from 12-1pm EST.

Place: www.facebook.com/IntegrativePelvicHealth

Remember this interview can be replayed later if you cannot view it live.

 

 

Resources for Pelvic Pain:

Beyond Basics Physical Therapy: http://www.beyondbasicsphysicaltherapy.com/

 

Heal Pelvic Pain: http://www.healpelvicpain.com/

 

Integrated Women’s Health Institute: http://integrativewomenshealthinstitute.com/

 

Link to hear Amy and many other wonderful pelvic health experts speak in December about the female athlete and pelvic floor dysfunction:

https://km132.isrefer.com/go/WIWH/AStein/

 

Live (Yesterday) from New York!

By Riva Preil

Even if you snoozed, you DIDN’T lose your chance!  If you missed yesterday’s live episode of The Pelvic Messenger, May the Floors Force Be With You with Diane Lee, you can STILL listen to it and enjoy her knowledge and wisdom. I feel blessed to have had the opportunity to interview such a renowned clinician and educator, and I am pleased to share my reflections on the experience with you.

Diane opened the conversation with a description of her professional journey and telling us about her role models.  She then described the Integrated Systems Model and explained the difference between form closure, force closure, and motor control.

Diane also elaborated upon various postpartum issues that mothers may face, and she shared helpful hints with listeners regarding how to address those problems.  (I don’t want to spoiler alert y’all and ruin the excitement for you, but I WILL give you a hint: Baby Belly Belt. Listen to the show, link below, for more details!)

Diane proceeded to discuss some of her most rewarding experiences as a physical therapist, and she whet our appetite for her upcoming International Pelvic Pain Society presentation (October 22-26 in Chicago, Illinois).  She also described her upcoming exciting trip to South Africa, where she will work with other PTs to educate health care providers and treat underprivileged women. One of my favorite parts was when Diane extended a PERSONAL INVITATION to me to join her on her medical mission!

It was an honor and privilege to (virtually) meet one of MY role models, and I encourage you to sit back, relax, and enjoy the show.  Comments and feedback are warmly welcome- this was my first show (!) and I would love to hear your thoughts 🙂

http://blogtalk.vo.llnwd.net/o23/show/6/640/show_6640983.mp3

P.S. The interview starts 1 minute and 13 seconds into the show, so don’t be alarmed if you don’t hear anything for the first minute or so. ENJOY!    

Shout Out About…IPPS Silent Auction

By Riva Preil

The International Pelvic Pain Society (IPPS) was established in 1996 with two primary objectives: 1) To educate health care professionals on how to diagnosis and manage chronic pelvic pain and  2) To bring hope to men and women who suffer from chronic pelvic pain by significantly raising public awareness and impacting individual lives.

IPPS’s mission is focused on optimizing the diagnosis and treatment of patients suffering from chronic pelvic pain and serving as an educational resource for health care professionals. As a not-for-profit organization, IPPS is broadly funded by donations and memberships from individuals, patients, and healthcare professionals alike. Your support of IPPS allows valuable educational programs that work the betterment of the diagnosis and treatment of patients suffering from chronic pelvic pain.

On that note, the IPPS is currently conducting an on-line silent auction to fundraise on behalf of their incredible work.  There are three categories of auctioned items:

  1. Pelvic pain products and education: examples include Amy Stein’s Heal Pelvic Pain book, Apex Automatic Pelvic Exerciser, an App for pelvic pain to help both the patient and the practitioner, perceptorship with Rhonda Kotarinos in Chicago, acupuncture perceptorship with Paula Haberman in NYC, De-mystifying Pudendal Neuralgia Course (for a practitioner, in Las Vegas September 2014), and a crystal wand.

  2. Travel and Leisure– examples include a week-long vacation to St. James’s Club, Antigua, a vacation in Dardanelle and Istanbul, Turkey, a 5 day/4 night Mexican Vacation at the Hacienda Tres Rios (Riviera Maya), 2 seasons tickets for the Chicago Blackhawks 2014 season, and 2 tickets to the Chicago Shakespeare Theater.

  3. Other miscellaneous products include NBC’S TODAY SHOW: VIP Behind-The Scenes Tour  for Two, $50 Gift Card Lettuce Entertain You Restaurants, jewelry, Starbucks and Apple Product Gift Cards, and a 16-Bottle Countertop stainless steel wine cellar.

As you can clearly see, there is something for everybody!  This is an incredible opportunity to win great prizes while supporting an extremely worthwhile cause.  Stay tuned for an interview with Amy Stein, Secretary of IPPS Board of Directors and Chairperson of the 2014 silent auction and for more details!

Opinions from Orlando

By Riva Preil

The IPPS hosted its Annual Fall Meeting on Pelvic Pain October 17-19, and I promised that I would update you on the conference.  Today, I am excited to share with you the thoughts of two of our physical therapists, Dania Kafka and Mary Hughes, both of who were present at the conference.

1377412_10151701166815334_2103370972_n

Dania:
Overall the IPPS conference was the 3 I’s – interesting, informative, and insightful. The interesting topics discussed included medical/surgical, physical therapy/musculoskeletal, and psychological/mental health. One lecture was about the multi-disciplinary approach in the treatment of pelvic pain.  Another lecture provided an overview on the Vulvodynia Registry, a study that involves collecting data from various clinical sites across the United States. Other topics covered were bladder, bowel, and sexual dysfunction, as well as pelvic pain syndromes. The highlight for me was the post-conference course on the Movement Impairment Syndromes approach for pelvic pain/pelvic floor dysfunction given by Theresa (Tracy) Spitznagle, PT, DPT, WCS. She was awesome! Tracy introduced the theory behind Shirley Sahrmann’s movement approach.  Shirley Sahrmann, PT, PhD, developed this approach for the entire body with her colleagues at Washington University Program in Physical Therapy. These syndromes are described in Dr. Sahrmann’s books, Diagnosis and Treatment of Movement Impairment Syndromes and Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spine. A Movement Impairment Syndrome can be localized painful conditions or other types of symptoms arising from irritation of myofascial, periarticular, or articular tissues, as a result of mechanical trauma, most often microtrauma. Tracy discussed the theory and gave us an introduction to evaluation and treatment of pelvic pain related Movement Impairment Syndromes (i.e., hip, low back, and sacroiliac joint).  It was excellent!

Mary:
IPPS was a great opportunity for me to meet physicians and other pelvic floor physical therapists. I work with many of the other health care providers on a regular basis, and it was nice to finally “put a face to the names” of my colleagues. Furthermore, as physical therapists, we were taught in school the importance of an interdisciplinary team approach.  It is great to see so many physicians open to the same idea, because it will enable us to provide the best plan of care for our shared patients.