| April 2008 · Vol. 20, No. 04 UPDATE
HOW DEVELOPMENTS ARE CHANGING PATIENT CARE
CHRONIC PELVIC PAIN
Are stimuli from damaged tissue, or maladaptive changes to the nerve supply, responsible for chronic pain syndromes? The answer may alter treatment.
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Fast Track
Full understanding of pelvic pain may come from studying changes in neurologic systems, not in gyn end organs themselves
Posterior tibial nerve stimulation has FDA OK to treat bladder irritability and other conditions
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John
F.
Steege,
MDDr. Steege is Professor of Obstetrics and Gynecology at the University of North Carolina School of Medicine in Chapel Hill.
The author reports no financial relationships relevant to this article.
A common thread ties together the studies and developments highlighted here: the notion that maladaptive changes in the neurologic supply to pelvic organs may contribute to chronic pain to a greater extent than do stimuli from damaged tissue. This understanding is consistent with the general lack of any obvious relationship between the degree (i.e., volume) of tissue change in disease (e.g., endometriosis) and the intensity of associated pain. It may also open new avenues to the prevention and treatment of chronic pain.
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