Thanks Faith,
I haven't been on the forum for a while, so I'm not sure if you have read the Guide to chronic pelvic pain, 2012?
It's on the home page. It attempts (rather well, I think) to distinguish between CRPS, which they term CPPS (Chronic pelvic pain syndrome) and CPP (actual symptomatically accountable Chronic Pelvic Pain, like PN, PNE, tarlov cyst etc)
I realise that CRPS can extend further than the pelvis but this particular publication is from urological/gynaecological specialities, so does not go beyond that area.It does address brain and CNS plasticity and the many other reasons that pain may exist to a chronic stage, when any initial tissue damage
should be recovered.
The major medical chronic pain explanation and medical focus now being this CNS change (plasticity) and then of course the proposed treatment for this type of chronic pain. I do worry about this however in connection with actual pelvic neuralgia especially with pelvic nerve damage and/or entrapment .
My worry is nothing to do with the advised treatment for CRPS or CPPS when
pain is the disease so to speak. I think they have got all of that well covered especially with all of the buzz about the brain and pain, plus the current research, tests and studies . After all it is the popular diagnostic choice now for any chronic pelvic pain sufferer, sorry!
any chronic pain sufferer, without no medical explanation for the pain.
And THAT is the problem! Because pelvic nerve issues are so under-recognised, it is far too easy for an actual pelvic nerve (PN, PFCN. cluneal, sciatic just to mention a few (mine
)) when there is actual tissue (in this case pelvic nerve) damage to go undetected. Because (1) medics (usually) don't know enough about the problem (2) they/it can't be seen/imaged (usually) and (3) it/they can't always be tested with any great degree of accuracy, so what chance is there, of almost every single one of us being wrongly allocated to the 'syndrome'/'pain as a disease' group.
(I know that is where I am now, according to two local medics anyway, although they are also back to exploring a spinal pathology now too. I feel as if I have travelled backwards in time, as I have been there and done that, almost 5 years ago!)
The problem as I see it, is that the chronic pain
syndromes are often linked to a focus on pain, depression, hyperalgesia, allodynia, stress leading to related muscle tension and more pain, which are precisely the symptoms an actual PN sufferer has!
So the conundrum continues! Not only that, it is actually potentially exacerbated because the more up to date pain management thinking about chronic pain will only allow it to be.
Take care,
Helen