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Expert Advice-Treatment of Chronic Pelvic Pain in Traditional Chinese Medicine(TCM):

A Tradition of Overcoming Chronic Pelvic Pain

For many women, chronic pelvic pain (CPP) is an ongoing nightmare Ė a health problem that they have to live with every day for months or years. Sometimes their doctors know why they suffer from this pain, but can do nothing to relieve it. Even more frustrating are the cases where conventional medicine can find no organic cause for the pain. These women are often given anti-depressants and told the problem is in their mind.

CCP Case Studies 
To illustrate the forms that chronic pelvic pain (CPP) can take, I will present four case studies of patients who came to my clinic. Then I will discuss these cases from the perspective of traditional Chinese medicine.

Elaine, 36, has been suffering from CPP for five years. Initially, she was told that the pain was due to endometriosis, and she had two surgeries to try to correct the problem. When that surgery was unsuccessful, the doctor recommended a total hysterectomy, which Elaine had done three years ago. At first the pain was better, but within a few months after having the hysterectomy, the pain was not only back, but was even worse than before. Now the pain is so severe that Elaine is almost disabled by it. She canít work, and spends much of her time in bed, holding her abdomen. She has seen many practitioners for pain control over the last three years, but nothing has worked for her. When she came to see me, she cried and said, "Iím just too young to be in this kind of pain." I diagnosed Elaine in Chinese medicine terms as a case of Blood Stagnation, and treated her with acupuncture and a Chinese herbal formula. After a few weeks, her pain began to decrease.

Karen is a single woman in her early 40s. She has suffered with CPP for more than fifteen years. According to her doctor, it began with a vaginal infection which traveled into her Fallopian tubes. She has been taking antibiotics, one after another, for many years, and still the pain from this "infection" persists. Because of the pain, Karen cannot hold a job for more than a few months. She is anxious and depressed, and canít sleep, so she also takes sleeping pills and anti-depressants. Her case falls into the Chinese medicine category of Damp Heat.

Jenny is a nurse with two children. Both of Jennyís children were born C-section, and it was after the second delivery that she began to have pelvic pain. She was told that it would be better in a few months, so she waited a few months, and then waited a few more months, but the pain never diminished or went away. Now it has been nine years. She has been to see internists, surgeons, a gynecologist, and a gastroenterologist, but no one can explain why the pain persists. One of the surgeons suggested that it was possible that some nerves had become trapped in the scar tissue from her last C-section. The pattern that Jenny exhibits is Chronic Deficiency.

Jody has been looking for answers about CPP for a decade. After a series of doctors and specialists could find nothing wrong with her, she was referred to a psychiatrist, who prescribed anti-depressants. Once Jody had been diagnosed with a mental condition, conventional physicians didnít want to see her anymore. They would just shake their heads and say there was nothing they could do for her. One time, when she was suffering from extreme pain, Jody went to see her gynecologist. Before she was done explaining her symptoms, the doctor interrupted her and told her he had heard enough, there was nothing he could do for her, and the only thing he could tell her to do was to go home and take her anti-depressants. At this point, even Jodyís husband and family didnít believe that she had chronic pain. Every day, Jody had to live with pain that no one believed in and no one could help her with. In Chinese medicine theory, Jody falls into the pattern of Liver Chi Stagnation.

Based on these cases, you can see that CPP can result from a number of conditions including endometriosis, tubal infections, C-sections, gynecological surgery, chronic cystitis, and physical or sexual abuse. Sometimes, no reason at all can be discovered for the pain. Additional symptoms that women with CPP may complain of include backaches, lethargy, headaches, heart palpitations, nausea, sexual difficulties, depression, anxiety, and insomnia.

Traditional Chinese Medicine for CCP
Traditional Chinese medicine (TCM) is a very complex and comprehensive system of medicine that has a three-thousand year history in China. When a patient comes to see a Chinese medicine practitioner, the practitioner listens to the patientís history, makes observations, looks at the tongue, and feels the pulse. Diagnosis is based on a consideration of all the signs and symptoms, and is expressed as a pattern, such as the patterns of Blood Stagnation, Damp Heat, Chronic Deficiency, and Liver Chi Stagnation mentioned above. The exact treatment prescribed for the patient is based on the pattern diagnosis, but most treatment consists of acupuncture, Chinese herbal formulas, and advice on dietary changes and lifestyle considerations.

Some cases of chronic pain seem to begin with a definite incident, such as Karenís original infection, or Jennyís C-section. Others come about gradually, with increasing discomfort over a period of months or years, and are often the result of poor diet or unexpressed emotions. Because Chinese medicine is holistic, the practitioner considers the emotional and lifestyle background of each patient to be as important as their physical symptoms. This approach is especially useful in a case such as Jodyís, when Western doctors canít find any organic cause. Liver Chi Stagnation is a condition that is generally based in emotional issues, especially unexpressed anger. The Liver is responsible for the smooth flowing of emotions and blood through the body, and when its energy is blocked, people can have symptoms of anxiety, high blood pressure, abdominal pain, indigestion, and menstrual problems.

Karenís Damp Heat condition may have resulted entirely from her original infection, but it is likely that she was predisposed to it because she was used to eating dairy, greasy, deep-fried foods, spicy foods, or alcohol. These types of foods overwhelm the Spleenís energy, and once the Spleen is unable to digest food properly, symptoms of Damp Heat can linger in the body for years.

With each of these cases of CPP, acupuncture, herbal formulas, and diet modifications improved the health and outlook of the women. While chronic conditions take longer to treat successfully than acute conditions, each of these women now understands her problem better, and feels optimistic that the worst is over, and good health is within her grasp.