Let’s not resign ourselves to chronic pelvic pain
“The diagnosis of chronic pelvic pain is an admission of diagnostic and therapeutic failure”: this is a harsh statement by Dr. Antonella Curcio, a gynaecologist who has been dealing with women’s intimate health for over 40 years, with a focus on listening to the painful situations that patients very often report to her.
Vulvodynia is a chronic pain syndrome that affects 12-15% of women in the world population. In Italy, a woman consults at least 7 doctors to get a correct diagnosis and about 30% fail to get it. A pathology that heavily affects women’s quality of life, social and couple relationships and that often remains hidden behind many taboos.
We talk about this with Dr. Antonella Curcio, gynaecologist and expert in gynaecological endocrinology, menopause and urinary incontinence in Florence
What do you mean by “diagnostic and therapeutic failure”?
By the time a woman comes to develop chronic pelvic pain, she has already had one or more ongoing pathologies for years. Pain is a symptom that is too often disregarded in a simplistic and frequent way in relation to the female patient who “has pain in her head”.
Chronic pain activates a kind of perverse loop, which, like a cyclone, is self-feeding, increasingly affecting a woman’s sexuality and, in particular, her sexual identity, sexual function and relationship.
If we do not understand this and do not intervene in time, the fire – because inflammation is a biochemical fire – changes its face and spreads. The tissue damage caused by the inflammation extends to the nerve fibres to the point of creating a kind of short circuit in the pathways of the transfer of the electrical impulses of pain. And so the pain appears to be of far greater intensity than one would expect.
What can we do not to get to this point?
First of all, the woman must not resign herself to the pain and ask (and demand) help from specialists.
We physicians must pay the utmost attention in the framing of the pathology and its management to achieve results in line with expectations. Listening to patients is fundamental, making them feel at ease even when talking about sensitive topics, without imposing a sometimes mortifying anamnesis. This is a very important point in dealing with the pathology of pain, which in many cases is related to pelvic floor hypertonus caused by the body’s defensive contraction in the event of pain.
Today we have therapeutic opportunities offered by technology, scientifically tested, which help us to improve the quality of life of patients.
A lot is said about vulvodynia, even creating some confusion. It is a very complex pathology, involving physical, pathological and psychological aspects. What resources are available to combat vulvodynia related to pelvic floor hypertonus?
I use the Dr Arnold device, a therapeutic chair that, thanks to its specific protocol for decontracting the muscles, is effective in improving vulvodynia related to pelvic floor hypertonus. In a nutshell, using this protocol results in a kind of technological physiotherapy: Dr Arnold emits electromagnetic waves that selectively stimulate muscle bundles, inducing very intense contractions and producing a relaxation of muscle tone until the tissue is rebalanced. The patient during the treatment, thanks to the induced contractions, also learns about mostly unknown muscles. This is why we talk about re-educational treatment and rehabilitation.
The results are excellent, also because the patient, dressed and comfortably seated, is very relaxed, feels no pain or discomfort and this contributes to the machine’s decontracting action.