Pelvic Pain Management
As a gynecological surgeon, Dr. Resnick found that a vast majority of his pelvic pain patients responded not to surgery, but to a broader approach in pain management that incorporated evaluating the patient’s immunology, gut function, hormonal balances, nutritional and metabolic deficiencies, and musculoskeletal components. We utilize a comprehensive approach to treat pain; we will consider your metabolism, neurotransmitters and inflammatory mediators; we incorporate trigger point injections and mind-body therapies to relieve the soft-tissue contributions to your pain; we will evaluate you for food and environmental triggers that are contributing to an immunological basis for your pain; and we will identify and manage your stress. All of the therapies are aimed at deconditioning the pain response, and providing your body with the building blocks needed to do so.
CFM is not a pill dispensary and will not prescribe narcotic medications. We will not refill any prescriptions. We offer a fresh and novel approach to the management of pelvic and musculoskeletal pain, and can work alongside your current medical regimen if you are requiring drug therapies. If you are needing to obtain a controlled substance, please continue to do so through your primary care or pain management physician.
CFM is not a pill dispensary and will not prescribe narcotic medications. We will not refill any prescriptions. We offer a fresh and novel approach to the management of pelvic and musculoskeletal pain, and can work alongside your current medical regimen if you are requiring drug therapies. If you are needing to obtain a controlled substance, please continue to do so through your primary care or pain management physician.
It is felt that a full fifteen percent of visits to a Gynecologist’s office are for a pain related issue. Considering the great number of women of all ages who see a gynecologist annually, with visits generally commencing at the late teens and continuing past menopause, it becomes clear that yearly there are millions of doctor visits each year for pelvic pain. And sadly, few women’s health specialists are truly equipped to address these concerns in a systematic and coherent way. Most medical providers respond to pelvic pain with a knee-jerk response, starting the patient on some type of hormonal regimen to regulate or perhaps eliminate the menstrual cycle altogether. The regimen undoubtedly includes the use of a medication such as ibuprofen (Motrin), and occasionally extends into the use of narcotic pain medications. Gynecologists, who are trained pelvic surgeons, may recommend a surgical procedure to look into the pelvis and possibly remove or repair a defective or damaged tissue. Some women, even in the face of absent pathology on pre-surgical (and intra-operative) evaluations, lose organs such as the uterus, fallopian tubes, appendix or ovaries.
And guess what. In many of these patients the pain doesn’t go away. In some cases the pain syndrome may worsen secondary to tissue changes resulting from the surgical procedure, injury to other tissues, or post-operative scarring. This is because the initial foray into the cause of the pain was misdirected, misapplied or misdiagnosed, and operating with a limited toolkit, the well intended physician or surgeon has actually made the problem worse. To be clear, there are many patients with pathology known or suspected prior to surgery who do very well, and have their pain resolved by the surgical intervention. Others are not so lucky, and are left with a diminished number of pelvic organs, diminished hope, and increased pain.
Dr. Resnick offers a specialized approach to pelvic pain based in his years of experience in women’s health care as a pelvic surgeon, and his insight into functional causes surrounding pelvic pain. To be clear, this approach to medicine is not intended for the pelvic mass or enlarged ovary, although arguably fibroid tumors may well respond to a functional perspective. At Chattanooga Functional Medicine we offer a greatly expanded toolbox to evaluate the multiple factors that could be contributing to your pain.
The first approach is to ensure that the patient’s hormonal symphony is in tune. It is well known that all pelvic tissues, from the external genitalia at the labia and anus, to the uterus, tubes and ovaries, are all responsive to hormonal fluxuations. Too often the conventional approach is to try a “one size fits all” approach by placing a woman on hormonal contraception that comes in the form of a standardized pill or a cream. A woman’s physiology is far more complex than simply starting the newest birth-control pill. It is incomprehensible to think of attempting to optimize a woman’s hormones by addressing only estrogen and progesterone, the main components in a birth control pill. All of the sex hormones, including testosterone, DHEA, pregnenolone and estrogen metabolites should be examined. Proper thyroid function is essential, and cellular energetics mediated through the hormones cortisol and insulin should be optimized. Stress, and the inflammatory processes that result from imbalances in cortisol, contribute strongly to the pain process and become a part of the treatment plan. Other factors, such as metabolic function, cellular energetics, detoxification pathways, and neurotransmitter function all contribute to the treatment toolbox.
Another factor which is truly unique to CFM in its approach to pelvic pain is the evaluation and management of pain components that are associated with the musculoskeletal system. An injury to pelvic musculature, in the form of spasm, damage, scarring or a sustained contracted state, produces a phenomenon known as a trigger point. A trigger point is a taut band of muscle external to the pelvic tissues that produces a pain syndrome that is often perceived as a pain coming from the pelvis. The first trick is to understand that pelvic pain is not exclusively limited to pelvic structures. These additional structures, such as the skin, muscles, fascia, gastrointestinal tract and bladder all must be considered and treated.
Dr. Resnick has helped women to regain their lives, work and sexuality through the use of trigger point injections, performing no fewer than a thousand trigger point injections over the years. These utilize a local anesthetic, are administered in the office, and if not fully curative provide weeks to months of improved pain. By utilizing a functional lens, and understanding the strong influence of tissues outside of the typical pelvic organs, CFM offers a new foundation and a new perspective on the challenges of pelvic pain.
What's Next?
Contact us to setup your New Patient Appointment.
And guess what. In many of these patients the pain doesn’t go away. In some cases the pain syndrome may worsen secondary to tissue changes resulting from the surgical procedure, injury to other tissues, or post-operative scarring. This is because the initial foray into the cause of the pain was misdirected, misapplied or misdiagnosed, and operating with a limited toolkit, the well intended physician or surgeon has actually made the problem worse. To be clear, there are many patients with pathology known or suspected prior to surgery who do very well, and have their pain resolved by the surgical intervention. Others are not so lucky, and are left with a diminished number of pelvic organs, diminished hope, and increased pain.
Dr. Resnick offers a specialized approach to pelvic pain based in his years of experience in women’s health care as a pelvic surgeon, and his insight into functional causes surrounding pelvic pain. To be clear, this approach to medicine is not intended for the pelvic mass or enlarged ovary, although arguably fibroid tumors may well respond to a functional perspective. At Chattanooga Functional Medicine we offer a greatly expanded toolbox to evaluate the multiple factors that could be contributing to your pain.
The first approach is to ensure that the patient’s hormonal symphony is in tune. It is well known that all pelvic tissues, from the external genitalia at the labia and anus, to the uterus, tubes and ovaries, are all responsive to hormonal fluxuations. Too often the conventional approach is to try a “one size fits all” approach by placing a woman on hormonal contraception that comes in the form of a standardized pill or a cream. A woman’s physiology is far more complex than simply starting the newest birth-control pill. It is incomprehensible to think of attempting to optimize a woman’s hormones by addressing only estrogen and progesterone, the main components in a birth control pill. All of the sex hormones, including testosterone, DHEA, pregnenolone and estrogen metabolites should be examined. Proper thyroid function is essential, and cellular energetics mediated through the hormones cortisol and insulin should be optimized. Stress, and the inflammatory processes that result from imbalances in cortisol, contribute strongly to the pain process and become a part of the treatment plan. Other factors, such as metabolic function, cellular energetics, detoxification pathways, and neurotransmitter function all contribute to the treatment toolbox.
Another factor which is truly unique to CFM in its approach to pelvic pain is the evaluation and management of pain components that are associated with the musculoskeletal system. An injury to pelvic musculature, in the form of spasm, damage, scarring or a sustained contracted state, produces a phenomenon known as a trigger point. A trigger point is a taut band of muscle external to the pelvic tissues that produces a pain syndrome that is often perceived as a pain coming from the pelvis. The first trick is to understand that pelvic pain is not exclusively limited to pelvic structures. These additional structures, such as the skin, muscles, fascia, gastrointestinal tract and bladder all must be considered and treated.
Dr. Resnick has helped women to regain their lives, work and sexuality through the use of trigger point injections, performing no fewer than a thousand trigger point injections over the years. These utilize a local anesthetic, are administered in the office, and if not fully curative provide weeks to months of improved pain. By utilizing a functional lens, and understanding the strong influence of tissues outside of the typical pelvic organs, CFM offers a new foundation and a new perspective on the challenges of pelvic pain.
What's Next?
Contact us to setup your New Patient Appointment.