When it comes to pain, the brain doesn’t always get it right.
Pain is a ‘protector’, not a reliable measure of tissue health.
Your pain is exactly what you say it is – and it’s not in your head.
Pain scientists are discovering more and more about the reality of persistent pain with an absence of physical stimuli.
The way we perceive the body is built on the brain’s image of the physical form.
Our lived experience of our bodies is informed by thoughts, beliefs, experiences and traumas, all of which may impact pain.
Eradicating pain is more than a matter of just sitting up straight or stretching areas that are stiff.
Learning to hold and move your body in a more skilful way can have a profound impact on aches and pains.
“The pelvis is shrouded in mystery, taboo and cultural differences…It is not discussed at the dinner table.”
So began physiotherapist and pelvic pain expert Carolyn Vandyken’s webinar, Moving Beyond Stretching: Tension is a ‘Top-Down’ Thing.
With attendees from as far afield as New York, Alberta, Lisbon and Llanelli, Carolyn’s illuminating presentation and the subsequent discussions didn’t happen across the dinner table, but rather across the globe.
This stands testament to the universal problem of chronic pelvic pain (CPP), which strikes regardless of geography, class and gender.
Yet as Carolyn mentioned, one of the reasons patients and healthcare professionals worldwide continue to struggle with resolving CPP could be misconceptions around its root cause.
Carolyn said: “We should think of tension as a top-down process, and not necessarily a tissue-based process…The brain may make pain if it thinks something is going to cause injury, but it doesn’t always get it right.”
Even the definition of a condition such as vulvodynia acknowledges pain in the vulva with an absence of tissue damage.
And while prostatitis might be inflammatory, it is often impossible to pin down the cause.
Carolyn said: “People are made to think, ‘It’s all in your head.’ But pain is a brain ‘thing’ – not a head ‘thing’.”
So if the brain is misfiring pain messages, creating bodily aches that are absolutely real but not tissue-based, what can be done to help?
Body mapping exercises, together with learning to move differently, form a large part of Carolyn’s approach.
She said: “I use the Chinese exercise system, Qi Gong, with my patients. I have been fascinated by it because it is such a simple technique. It helps you move your body in a more skilful way, using your breath.”
Attendees also heard from Tara Moffatt, a patient of Carolyn’s who developed a slew of pelvis-related symptoms after an operation to remove a rare teratoma tumour.
Tara said: “Admittedly I wasn’t entirely on board at first, but since I have taken on the approach, it has been mind-blowing.”
A practical sitting exercise followed, during which Carolyn guided the audience through a series of relaxed poses, each subtly changing posture and the corresponding sensation in the pelvis.
Many noted that even after just 10 minutes, they could notice a difference in how it felt to sit.
Carolyn said: “If I can teach my patients to sit less guardedly, they may feel the benefits. Body mapping exercises target the brain, changing the stiffness and pain.”
The session also featured valuable contributions from Malina Kelly, who helped develop the Fremantle Perineal Awareness Questionnaire, and the colorectal and pelvic floor surgeon, Shahab Siddiqi.
Our thanks to everyone for helping us with another very insightful event.