Neurocentric approaches to treating pelvic pain with Dr Sandy Hilton

You can watch our chat here.

This is a Really exciting time in pelvic health where our understanding of the brain, pain and how we can change someone’s experience are all evolving. By this I don’t just mean in the psychological way, but in a true “pain experience” sense as well as thinking about how we can change biological markers and antecedents to pain, such as inflammation, with our words and how we approach people with chronic pain.

Sandy Hilton is a Doctor of Physical Therapy based in Chicago, America. She has contributed to multiple book chapters, papers, and co-authored “Why Pelvic Pain Hurts” and is an international instructor and speaker on treating pelvic pain for professionals and for public education. She’s also a regular contributor on health related podcasts, and is co-host of the Pain Science and Sensibility Podcast with Cory Blickenstaff, which I can wholly recommend as both a source of evidence and a great lesson in how...

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New metabolic markers for bladder pain syndrome/interstitial cystitis

New metabolic markers and histopathology findings for bladder pain syndrome/interstitial cystitis

As part of my recent “what else is out there?” literature review I came across two papers I thought you may be interested in. They look at potential new markers for BPS. What I find interesting is the numerous angles in which people are approaching this problem. It’s good to get out of our comfort zone, test our theories and be reminded of biologically plausible reasons for pain when we work in the emotionally and centrally driven world of pelvic pain so often…

I’d love to hear what you think!

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Graded motor imagery and sensory integration for pelvic pain + IC/BPS

Graded motor imagery for pelvic pain + IC/BPS – should we be incorporating other senses? Watch the vlog here.

It’s time to be honest. Working in pelvic health can sometimes be lonely, in the UK we’re often in tiny clinics away from our teams. I’m certainly someone who thrives on discussing, debating and being challenged. So here are some of the things I’ve been doing with Graded Motor Imagery, how I’m approaching it at the moment and the realities of how it’s going – it takes time!

If you’ve got any comments, are using GMI or are passionate about treating or researching BPS I’d love to hear from you! Only from sharing our knowledge do we all improve. At the end of the day, that’s my mission – getting better at getting people better. Enjoy!

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A quick guide to the what and why of Interstitial Cystitis / Bladder Pain Syndrome

What is Bladder Pain Syndrome?

The first thing to say about Bladder Pain Syndrome is what it’s Not….

Initially people went to their doctors with the symptoms of a chronic infection – a urinary tract infection or cystitis. They had an urgent need to pass urine, felt like they needed to go often and it would be accompanied by pain in the bladder region, perineum (between the legs) or in the urethra (tube from the bladder). However this went on much longer than an infection should, and often after taking antibiotics. The lining of the bladder is called the interstitium and so it was thought that when people presented with this group of symptoms they had a chronic infection of the bladder lining. This is how the name Interstitial Cystitis came around.

It’s now understood that Interstitial Cystitis/Bladder Pain Syndrome is much more complex, and many people do not have a chronic infection of the bladder or urethral lining. Even If they do have a chronic...

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Does a c-section increase your risk of bladder pain?

Watch the vlog here.

A few weeks ago I was given this paper by Gill Brook (thanks Gill!), and I think it’s another important step forwards in our knowledge about the aeteology of Bladder Pain Syndrome.

The full title of the paper is:
Will cesarean section increase the risk of interstitial cystitis/painful bladder syndrome?
Kun-Min Chang, Ming-Huei Lee, Hsuan-Hung Lin, Shang-Liang Wu, Huei-Ching Wu
Neurourology and Urodynamics. 2018;1–7.
DOI: 10.1002/nau.23704

Have a listen, I’d love to hear your thoughts! Catch me on Facebook or Twitter.

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Knowledge Bombs from the World Congress on Abdominal and Pelvic Pain: Part 1

I had an absolutely inspiring time at the World Congress on Abdominal and Pelvic Pain in Washington recently. I was given the opportunity thanks to the Dame Josephine Barnes award from the POGP and the EPIC Scholarship from Entropy Physiotherapy in Chicago and Lorimer Moseley. I can’t thank them enough for supporting the education and development of clinicians who wouldn’t otherwise be able to attend world-leading conferences such as this one. It truly was EPIC.

I’ve gone back through my notes and pulled together some of the things I think are important and have great clinical translation. It helped me to gather and retain the information and I really wanted to share what I learned. Better informed clinicians providing up to date evidence-based therapy are going to be the best for our patients, and at the end of the day this is why we do what we do. Apologies to any of the researchers for inaccuracies, these are just a few teeny pearls of wisdom I took/understood...

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How to heal your pelvic pain using a wand… it’s better than magic!

Head over to my YouTube Channel to hear all about how to use the Wand in Pelvic Pain.

Persistent pelvic pain can be devastating. Though not necessarily the cause of your symptoms, often the pelvic floor muscles at the base of the pelvis are in spasm and having them manually released or gently stretched by a specialist pelvic health physiotherapist can relieve symptoms.

If this is the case you can use a therapeutic wand (or your own thumbs!) to get the same relaxation in your pelvic floor by yourself at home. This is great for those moments when you have to take a long car journey or eat something that sets off your pain – use the wand and hey presto! You’re feeling a bit better again. Doing this regularly alongside physiotherapy can really help you to change your symptoms and to feel confidently in control of your own body again. It’s not for everyone, but if you feel this might help you, keep reading…

The secret is… It’s not about the wand....

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One story changed my life and led me into research

“It’s like having the worst urine infection, but all the time. I can’t work, I can’t sleep, my relationship is suffering because its too painful to have sex so I don’t want him near me, and I feel ratty all the time. I’m not being a good mum, I shout at the kids. I’ve had enough.”

I first came across Bladder Pain Syndrome (previously known as Interstitial Cystitis) 10 years ago when one woman’s story really hit home. A young mum who’d had to stop working as her trips to the toilet every 15 minutes were annoying her boss, and her colleagues made jokes about her bladder. It was initially something she handled well, but as she tried to hold off from going to the toilet her symptoms worsened and she retreated inside herself. Medications didn’t help the pain and quickly her world became smaller and smaller.

Her bladder was ruling her life and she was miserable. She was at the end of her tether and I was her last hope.


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