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Anyone know what this chronic pelvic pain is?

post #1 of 9
Thread Starter 

I've had it since I was pregnant with ds, who is almost 3.  It mostly started in my 3rd trimester.  I thought it would go away after the birth, but instead it was so much worse.  It's a heavy, dull, ache in my vulva.  Right after the birth it hurt all the time, but after a couple weeks it was only when I was standing for more than a minute or two, especially if I was carrying/wearing ds.  When I was pregnant it was just when I was standing for long periods of time.  It gradually got a little better as the years went by after ds was born, but never really went away.  After he turned 2, it was mostly just bad the first day or two of my period, and the day or two around ovulation.  Sometimes it would be mild during my luteal phase.  I am pregnant again, 20 weeks now, and it's getting worse.  I can't stand for more than a minute or two before I start feeling the first twinge. It starts to get painful after about 10.  The pain is never intense, but it really interferes with cooking/dishes/waiting in lines.  I feel like I've been sitting down for 3 years.  I'm really scared it's going to be bad again after the birth, it was such a slow recovery, and not even a complete one at that!  I had a homebirth, I thought labor was relatively easy (yeah it was hard, but I thought it would be worse) pushing was frustrating for me.  It took 2 1/2 hours of hard pushing.  He was in a good position, and only weighed 6lb9oz.  I had a small tear that was stitched, and healed well.  We're planning another homebirth, and I'm really hoping that the pushing phase is shorter.  In hindsight, I think I could have waited to push with ds, I didn't have a strong urge when I started pushing last time. 

 

Over time, I've found a few things that help.  Switching from Dansko clogs to the flattest flats I could find seemed to help.  Any position that stretches or allows me to more fully relax my pelvic floor will take the pain away momentarily; things like squatting, putting one leg up on a chair if I have to stand, laying down with legs spread really wide apart.  A hot rice pack right on my crotch helps.  As I've mentioned standing makes it worse, the longer I stand, the worse it gets.  Also anything that adds pressure to the pelvic floor makes it worse, carrying heavy loads (like my toddler), or bearing down to have a bowel movement.  It's also worse the day after I have sex.  During sex everything is peachy, but I pay for it the next day.  I didn't seem to have any prolapse issues after the birth, though I did see a Mayan Abdominal Massage therapist once right before I got pregnant this time. She said my uterus was sitting a touch low, and leaning over to the right.  She moved it back in place for me, which felt awesome, but didn't seem to make a difference in the pain.  It was pretty much gone for the first couple months of pregnancy, it was so nice!  But now it's back, earlier and worse than it was last pregnancy.  I'm seeing a pelvic floor physical therapist right now, it's been 3 or 4 weeks, and it doesn't really seem to be helping.  I was expecting some internal exams with the therapist, but none so far.   She did say that my pelvis is crooked in a couple of ways, and gave me exercises to correct that, and taught me how to tell when it's out of alignment.  I do the exercises, it appears to me that it corrects the misalignment, but it doesn't seem to touch the pain.  She also found some bands of tension in my inner thighs, that she massaged vigorously (yowch!)  That did seem to change the sensation of the pain.  It still came on just as readily, but it was more forward, like around my urethra instead of back around my vagina.  I'm supposed to stretch my inner thighs a lot to keep the tension from coming back, but the stretches she gave me are now causing pain around my pubic bone (probably due to pregnancy/relaxin).  I'll ask for alternative stretches at my next appointment. 

 

Nobody can tell me what is causing the pain, or how to fix it.  I can't even find anyone else that has experienced it.  For some reason, I've grown really emotional about it (pregnancy hormones, maybe?).  I'm just so tired of sitting down at social events while everyone else stands around and mingles, and burning dinner because I sat down to take a break while something was on the stove, and doing my dishes 10 minutes at a time because I can't stand there long enough to just get the job done.  I wouldn't care if it was just during pregnancy, but my last birth just made it so much worse.  How am I supposed to take care of a toddler if I can't carry my newborn around while I'm chasing after him? 

 

Has anyone heard of this?  Have any ideas?  Commiseration?  I'm just miserable about it.

post #2 of 9

I wonder if homeopathic sepia would help?? I get dragging sensations too and they are to do with varicose veins in my pelvic area, but sepia and some tissue salts that my homeopath prescribed help. I would see a homeopath. I've also had Bowen therapy, McTimoney chiro treatment and use reiki on myself in that area for relief.

 

There are tight knickers one can purchase for labial varicose veins, which might give you a feeling of support. I've never tried them because I can't stand the feeling of tight clothes!

post #3 of 9
Thread Starter 

My sister had vulvar varicosities during her later pregnancies, and had to wear a support belt thing.  I don't have any visible varicosities, but I think it's possible to have them hidden up in your pelvis somewhere, right?  I emailed my sister last night to ask her which one she had.  I don't know that it will help, but I'm willing to trying nearly anything at this point. 

post #4 of 9

yes, they don't need to be bulging out all over the place, but if you look close you might see more blue than you'd expect (if you're caucasian)

 

sepia is for dragging feelings and the childbearing years generally and can be taken in all kinds of doses that a homeopath can work out to your best advantage. i hope you find some relief and hope hug2.gif
 

post #5 of 9

What you have is a classic case of pelvic floor dysfunction.

 

I have been dealing with pelvic floor dysfunction since i had a bartholin's abscess removed a few years ago.

 

you are doing the right thing by going to PT, however, to be frank, your PT doesn't know what she's doing!

 

If you are getting PT for pelvic pain, the most important treatment you can receive is internal work and by that I mean that the PT via your vagina works to lengthen your too tight muscles and also to identify and work out any trigger points you might have anywhere within your pelvic floor muscles. Either overly constricted muscles or trigger points are more than likely either involved or THE cause of your pain.

 

I live in Los Angeles and had to see a handful of PT until I found one that knew what she was doing. Two actually. It was the PTs at the Pelvic Health and Rehabilitation Center in SF that finally figured out exactly what was wrong with my pelvic floor and showed me what had to be done to fix it. From there I found a PT locally that had taken their course.

 

If you tell me where you live, I can ask one of the PTs if there are any PTs that have taken their course that practice in your area. With the right PT you can get 100% better!

 

They actually just posted an article on their blog describing in detail what a GOOD pt session is like:

 

You can find it here:

 

http://www.pelvicpainrehab.com/blog/2012/05/what-is-a-good-pelvic-pain-pt-session-like/

 

Also, two really great sources on pelvic pain are below: 

 

http://pelvicpainsupport.com/

http://health.groups.yahoo.com/group/happypelvis/

 

Please feel free to email me personally if you have any more questions. My email address is: bonniesheapr@gmail.com

 

Wishing you the best,

Bonnie

post #6 of 9

I think Bonnie was right on about finding a more thorough pelvic floor PT. 

 

I also think it would be worth it to revisit the Arvigo Maya Abdominal Therapist you saw previously, or find another. If they've had additional training in pregnancy massage, they should be able to help take some of the pressure off your pelvic floor, teach you to do the massage yourself to keep it up, and if you go regularly, it can even help shorten your labor..!

post #7 of 9
Thread Starter 

I did learn the self massage at my ATMAT appt.  Unfortunately, there are no therapists in my state.  I had to arrange to see the one I did over Christmas vacation while we were visiting family.  More fortunately, we'll be moving to that state in a couple of months, so I do plan on going back to her after the move.  I'm hoping she can help release my tailbone a bit, as my midwives at ds's birth said the space between my tailbone and pubic bone is kind of narrow, which is probably one of the reasons I had to push as long as I did. 
 

post #8 of 9

I had the same pain during my second pregnancy. I carry very low and I thought it might be some sort of varicose vein. I heard my sister had pain in that area too, and the doctors were thinking it was varicose veins. I looked in the area and only saw a faint blue spot...I thought with all that pain it would be bulging out...but no. It must have been internal, kind of like how hemmoroids can be internal. I started shopping on line for a support belt. I never got around to buying it because I went into early labor (31 weeks).

 

I can tell you that I was fine in bed and the moment I stood up I was in pain. Also, I have always been a very veiny person. I have had very pronounced blue veins behind my knees since childhood. They are much worse now at 40, after having two children. I don't know why I didn't get this sensation with my first pregnancy though. I also carried low, and I carried full term, although he wasn't that large. With the second pregnancy, my legs looked like they had bruises all over them. I got all sorts of weird spider veins and other junk...many of them went away, but my legs are still a mess. I think this is somewhat hereditary, because my mom always had tons of spider veins and my grandmother had to have surgeries for varicose veins...also because I think my sister may have had issues with pain in that area during pregnancy too. I heard being on hormonal birth control doesn't help either, which I was on for many years. I wonder if it has to do with my second child being a girl also. Perhaps the extra hormones?

post #9 of 9
Thread Starter 

Thanks for sharing your experience, jmarroq.

 

I took a good look with a magnifying hand mirror the other day when it was hurting.  I can see some bright blue veins, but none of them are bulging.  I can see veins through most of my body though, thanks to my super pale skin.  Of course, the skin down there is more pink than white, but I just don't know how veiny a vulva is supposed to look, ya know?  I got some support undies in the mail today, I'm really hoping they improve things.  We're moving in a few weeks, and I've got a lot of work to do. 

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