Endometriosis is a chronic condition where similar cells/tissue that line the uterus (endometrium) are also found outside the uterus on other parts of the body; including but not limited to, the ovaries, fallopian tubes, peritoneum, and bowels. In rare occurrences, the endo tissue can be found as far away as the lungs and eyes. Regardless of its location, this tissue responds to the female sex hormones released by the ovaries, resulting in monthly bleeding which can lead to inflammation and scarring. Unfortunately, this scarring doesn’t grow as nice linear fibers, it grows in abnormal directions, like tentacles, adhering to adjacent organs, muscles, and fascia. This can result in great pain and discomfort.
Unfortunately, endometriosis is estimated to affect up to 10% of women of reproductive age.
For some diagnosed with endometriosis, they experience little or no pain and for others, they experience a variety of pain ranging from
Chronic pelvic pain
Heavy menstrual bleeding
Painful periods
Painful intercourse
Lower back, hip & groin pain
Irritable Bowel Syndrome
Infertility
Lethargy
Studies have shown that there is no correlation between the extent of endometriosis and the amount of pain and discomfort experienced. Those with very little endometriosis can have extreme pain and those with extensive endometriosis involving multiple organs/muscles and fascia may have minimal pain/symptoms.
Management of Endometriosis
At Eastern Osteopathy, we believe that the most successful management of endometriosis, comes from having a multidisciplinary approach, involving a variety of health and wellness practitioners, including but not limited to;
Gynecologist
General Practitioner
Osteopathic care; both pelvic health trained (or pelvic health physiotherapy) and general osteopathy
Naturopathic Medicine
Acupuncturist
Yoga and Mindfulness
Pain Management.
We believe that it is important that your team listens and truly understands the complex nature of your illness, and acknowledges the impact that chronic pain has, on both your body and your emotions. On average it can take 6-10 years for a definitive diagnosis of endometriosis. So take your time finding your endo tribe, your endo team.
The Role of your Osteopath
Everyone’s story is different, and everyone’s experience of endometriosis is also very different. There is no ‘one size fits all’ approach to assisting women suffering from chronic pelvic pain associated with endometriosis. As with all chronic conditions, over time the nervous system can become sensitised and overactive. Basically, your threshold for pain is lowered to a point where only a small amount of painful stimuli can result in relapse and extreme pain. Our aim is to help to turn the volume down on your pain by calming your nervous system.
CASE HISTORY
A thorough case history is taken, including the full history of your presenting complaint, as well as, past medical history and any relevant traumas. We want to be aware of the different stresses present on your central nervous system. A heavy fall on your bottom twenty years ago could end up being a very important part of your pain picture.
WHOLE BODY ASSESSMENT & TREATMENT
The emphasis of osteopathic treatment is the whole person, not just their symptoms. As osteopaths, we have access to a wide range of techniques, enabling us to accommodate the individual needs of all our patients.
These techniques include:
Cranial osteopathy
Visceral manipulation
Soft tissue & myofascial techniques
Gentle joint manipulation
Stretching
Dry needling
Trigger-point therapy
Articulation
Osteopathic treatment will aim to remove any stress or strain through the fascia (including the visceral region), muscles, ligaments, and joints. This stress/strain may be loading your central nervous system, helping to create a higher threshold for activity. We will use manual therapy techniques to help relax your nervous system, remove stress and strain from ligaments, fascia, and muscles to improve overall movement and function. We will also aim to improve overall balance to encourage your body’s ability to self-heal.
Endometriosis is estrogen sensitive. What does this mean? It means those suffering with estrogen dominance can have an exacerbation of symptoms. Our osteopaths have a thorough understanding of stress, gut health and constipation, and the impact they have on the production and removal of estrogen as a waste product. With this in mind, we are able to advise on good gut health practices, as well as, stress management and mindfulness techniques.
TREATMENT WITH OUR PELVIC FLOOR OSTEOPATH.
An internal assessment of your pelvic floor can be an extremely useful tool in assisting women suffering from chronic pelvic pain associated with endometriosis. In general, as a response to pain, our muscles tend to tighten up; this includes the pelvic floor muscles. Tension within the pelvic floor muscles can be a major contributing factor to the pain experienced with endometriosis; locally causing pain and discomfort as well as referring pain throughout the pelvic region.
For many women suffering with endometriosis, it is also common to experience pain and discomfort during intercourse due to the tension found within your pelvic floor muscles.
As pelvic health osteopaths, we are able to use manual therapy techniques to help desensitise the pelvic floor muscles, as well as using internal myofascial techniques to release your pelvic floor muscles and fascia.
We believe an internal assessment of the pelvic floor, along with localised treatment, and desensitisation of the pelvic floor muscles is important, but it is by no means compulsory. If you’d like more information on internal assessments, please click here
Our pelvic health osteopaths have extensive training in visceral osteopathy. This is a technique that can be used to help mobilise the abdominal and pelvic organs and fascia to help break up scarring and adhesions associated with endometriosis.
MANAGEMENT
Endometriosis is a complex condition. When treating women who suffer from chronic pelvic pain associated with endometriosis, advising on the following is an essential part of our treatment plan:
Education on how to perform relaxed diaphragmatic breathing; explaining how to use your breath to relax tension (down-regulation) of your muscles including your pelvic floor and how your breathing can be used to relax your sympathetic nervous system that is often heightened by stress - as commonly seen in those suffering chronic pain.
Optimal toilet habits; education on good toilet habits including the use of the squatty potty, mindfulness, and breathing when going to the toilet, can help to relax the pelvic floor, allowing for ease of bowel movement and reducing the stress on the pelvic floor.
Mindfulness - which has been shown to reduce the perception of pain and stress levels.
Restorative Yoga can help calm your central nervous system.
Movement practices - Move, move, move. Getting your body moving in a gentle way and getting in touch with your body can help you learn to trust in your body again. This allows your brain to receive stimulus that you are moving, pain-free and without fear.
Gentle Yin Yoga - stretches to help any muscles and fascia that are restricting the movement of your pelvic floor, abdominal and pelvic region.
Advice on sleep - when sleeping, our body has time to recharge and recover and reduces stress.
Nutritional advice - As with any chronic condition, endometriosis is associated with chronic inflammation. Removing inflammatory food such as gluten, refined sugar and dairy can have a positive impact on pain.
Chew, chew and chew more - Mindfully and slowly chewing your food fully can help get the gastric juices flowing and by doing so, can help our stomach fully digest our food. This is an important first step in developing a healthy gut, and by doing so, the reduction of inflammation and pain.