Pelvic pain is tough. You can’t see it. You can’t reason with it. Scans are negative. There aren’t many answers and it’s your private parts we’re dealing with here. Enough said.

Any persistent pain can truly be life-altering for anyone going through it. This in itself can be a form of trauma, piled on top of all the other human life predicaments that may come our way. We all have different experiences and we all experience psychological distress in our lives in one way or another.

The coping mechanisms we use to get through life’s challenges are based on numerous factors... from how your parents dealt with pain or distress to social and cultural influences. When it comes to your genitals, this taboo subject adds another layer of complexity.

Dr. Dan Siegel, a clinical psychiatrist, describes what happens to our brains when we experience trauma or a perceived threat using a hand model.

Check out this video where I describe his model and how it relates to pelvic pain.

Pelvic pain is distressing, which makes it harder to act rationally. Not knowing why you hurt will make you hurt more and this further heightens the alarm systems in our bodies meant to protect us.

When this threat continues to linger for extended periods of time, a maladaptive neurological adaptation occurs keeping you stuck in the pain cycle until you change the story and turn things around. In other words, to make sure you don’t get stuck in that pain cycle, you need some strategies.

Anything that leads you to feeling helpless and hopeless can heighten your hypervigilance, keep your guard up, and throw your brain and body into survival mode. That’s even more so when you have no clue why you hurt. In short, the threat in your loins amplifies your brain’s protective mechanisms which can keep you in a sensitive state of arousal and pain.

So how can you train your brain to keep its cool with pelvic pain?

Play some brain games: Cross-body coordination exercises help us use higher brain level functions, which can change the way we respond to pain and flare-ups. Instead of using the fight or flight parts of the brain when we feel threatened (like in a flare-up or pain), we can change the brain to learn new ways of coping, making us feel calmer and happier, and lessening pain. Yay!

1. Tip tap fingers

2. Bow and arrow fingers

Breathing exercises: Breathing exercises help to calm an overly amplified nervous system. The areas of the brain that control respiration and blood pressure are the same areas ready to fire in the face of danger to protect you. So, you can use breathing to modulate your response to pain instead of being quick on the trigger finger to react, which only perpetuates the pain cycle.

1. Grounding breath with a focus on lengthening your exhalation

   1. Breathe in for 4 counts (for example)

   2. Breathe out for 4 counts

   3. Linger on your exhale for 2 counts

2. Alternate nostril breathing

1. Inhale and exhale normally for one breath cycle

2. Pressing your finger to the outside of your nose, close off the right nostril and breathe in through the left nostril

3. Switch and close off the left nostril and breathe out through the right nostril

4. Breathe in through the right nostril

5. Switch and close off the right nostril and breathe out through the left nostril

6. Repeat this cycle 5-10 times

Practice mindful movement: Movement is essential for life and for your recovery. Movement nourishes nerves and muscles, moves fluid and toxins in and out of the body, and supports your immune system. Mindful movement forces you to slooooowww down and bring your attention inward. Often with pain, we’re quick to avoid the feeling instead of just exploring the sensations in our body with curiosity and compassion. Restorative movement also acts to downregulate a hyper-aroused ‘fighty flighty’ nervous system (like breathing does). In fact, you’ll notice that most of these practices involve connecting your breath to your movement.

1. Restorative yoga

2. Tai chi

3. Qi gong

Non-painful touch: We don’t treat pain with more pain. Anytime you touch someone’s body, you’re tapping into their nervous system and changing the brain’s interpretation of the need for protection. Ultimately, you’re trying to create an environment and context that has a safety message rather than danger message. No need to grin and bear it.

1. Stop chasing trigger points (watch this video)

2. Practice pleasure not pain

The goal with all the strategies above is to reorganize and restructure maladaptive neurological processes. In other words, you’re creating a new trail, new grooves in your brain, by tapping into the higher functioning areas of the brain that deal with self-regulation, impulse control and rational thinking. As Donald Hebb said, “Nerves that fire together wire together”; the brain has the amazing ability to adapt and change.

Neurons are designed to change based on practice. So in order to change the response to a patterned stimulus (like pain), we have to create a new memory trail and new way for your neurons to fire that result in less need for protection, guarding, tension and catastrophizing. We’re training your brain and body to know that everything will be okay.

Be consistent and patient with these practices. Just as any new trail takes time to develop and maintain so will the neurological trails you’re cultivating.

Don’t wait until things get bad to practice these strategies. Instead, strengthen your resilience before a painful flare-up happens so you can feel empowered to handle the situation with greater ease.

When you keep your cool, treatments and problem-solving will be much easier, lessening the flare-up intensity, duration, and frequency.

This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.