Management of Pelvic Pain in Women with Endometriosis

Adequate management of pain is paramount in women with endometriosis, due to the chronic and debilitating nature of this painful condition. The type of treatments offered will depend on the type of pain, its severity and duration, and the specific needs and wishes of the patient.

What can be done about my pain?

Our aim is to offer permanent relief and resolution of pain through surgical and non-surgical interventions (excision surgery, nutritional counseling, pelvic physical therapy etc.). In some cases, however, short-term or ongoing pain management is required to allow our patients to function. Not all sources of pain can be resolved by therapeutic intervention and in some cases definitive treatments, such as hysterectomy for uterine disease, may not be desired due to a wish to preserve fertility. Instead, ongoing palliative management in the form of prescription and non-prescription drugs and interventional pain management (nerve blocks, pain pumps and catheters) may be required. Interventional treatments may warrant the specialist expertise of a pain-management physician who will work in close coordination with the rest of the patient’s healthcare team.

Non-prescription (over-the-counter) pain medications

Common non-prescription pain medications used by pelvic pain patients include Acetaminophen or Tylenol and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and naproxen, which suppress inflammation. Care needs to be taken to not exceed safe daily dosages of pain medication and, in particular, when combining different non-prescription and prescription drugs. It is important for your safety that even over-the-counter medications are disclosed and carefully discussed with your doctor when considering pain management options.

Prescription pain medications

Prescribed pain medications include prescription NSAIDS and narcotics. Narcotics can be short acting (e.g., hydrocodone, oxycodone and hydromorphone) or long acting (e.g., morphine and long-acting oxycodone). Narcotic pain medications work by slowing down or stopping the signals from the nerves to the brain. The choice of narcotics prescribed will depend on whether your pain is acute (such as post-operative pain) or chronic (ongoing pain).

Pain-narcotic contract

If a patient receives prescription-narcotic pain management, she will be required to enter into a pain-narcotic contract which specifies what she can and cannot do while taking prescription-narcotic pain medications. All members of her healthcare team are aware of this contract and regular meetings are held among the staff to discuss and monitor the patients who are receiving prescription-narcotic pain management.

Interventional pain management treatments

Interventional pain management treatments for long-term pain include pain pumps (an implantable pain-management device), spinal cord stimulators (pain catheters), trigger-point injections or nerve blocks (temporary numbing injections to painful areas or overly sensitive nerves), and radiofrequency ablation (RFA), where targeted nerves are “stunned”, offering more prolonged relief than nerve blocks.

At Vital Health we offer an array of options to both resolve your pain and to manage acute and chronic pain. We firmly believe that no woman should suffer from pelvic pain and we strive to provide optimal relief to each and every patient who comes to us for help. Even when a patient suffers from intractable pain that does not respond to surgical and non-surgical intervention, ongoing pain can be managed with a variety of palliative approaches, offering hope, relief, and restoring your quality of life.