Unraveling the Complexity of Chronic Pelvic Pain with Dr. Alime Büyük
Chronic Pelvic Pain (CPP) is a persistent pain felt in the pelvic region and lower extremities of both men and women, but is experienced more commonly by women. 1 in 7 women in the United States as well as many women globally endure CPP for years before being formally and accurately diagnosed. This is because women experience pelvic pain at varying intensities and durations as well as in different locations of the body (back, abdomen, etc.,). Additionally, various comorbidities, like vaginismus and/or dysmenorrhea, often result in misdiagnoses, incorrect treatments, and ultimately, an impaired quality of life for women going through CPP. The pain just doesn’t get addressed.
To better understand, assess and manage CPP, Dr. Alime Büyük, a pelvic physiotherapist and clinical investigator, recommends a multi-pronged approach. The myofascial component of CPP is often overlooked in favour of standard medical treatments. Dr. Büyük therefore advocates for treatments that combine physical medicine, rehabilitation, and education focused on musculoskeletal pain and visceral conditions.
Dr. Alime Büyük's journey into understanding pelvic health started with an interest in her own sexual health and wellness. Learning about her own pelvic floor issues led her to recognise the prevalence of pelvic problems among women. Pelvic exams and treatments can be uncomfortable, especially for women who have had unpleasant experiences or where there is stigma surrounding sexual health and wellness. She found this to be the case, through her research and experience as a clinician in a town named Alanya in Turkey. Dr. Büyük found that women were suffering through years of CPP in silence, and most commonly post-pregnancy CPP. During pregnancy, the weight of the uterus tends to elongate and weaken the pelvic floor muscles. The pain and other symptoms resulting from this are often dismissed as “normal” or temporary; something that will adjust over time. Even women who suffer from CPP due to organic pathologies, such as endometriosis aren’t given the appropriate care after even surgical interventions. This is because standard medical literature suggests that once the “source of the pain” is removed, there should be no pain. CPP is one of the most common reasons for gynaecological laparoscopies and yet, women experience debilitating pain, with a reemergence of endometriosis within 2 years post-surgery. Medical encounters such as these are a few of the reasons why women refuse to seek medical help at all.
In efforts to mitigate the misconceptions surrounding CPP, Dr. Büyük underscores the importance of certain physical examinations such as palpating the pelvic floor. The pelvis consists of interconnected muscles and nerves. Through palpation, there is a better chance of identifying the myofascial trigger points that result in central sensitisation and allodynia (pain from non-painful stimuli). Myofascial Trigger Points (MTrPs) are hyper-irritable nodules that reproduce pain when engaged. Identifying where these pain spots are can help in coming up with targeted treatment plans that alleviate and manage chronic pain. Our episode with Dr. Shah and Dr. Srbely, as well as our blog on their joint research help explain MTrPs and central sensitisation in greater detail.
Empowering Women through Muscle and Movement
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Overall, Dr. Büyük emphasises the importance of empowering women, educating patients and providers, understanding the complexity of pelvic pain, and challenging traditional beliefs surrounding reproductive and sexual health. Complex and interconnected medical conditions such as CPP require comprehensive assessments, specialised care, and ongoing awareness efforts to improve the management and care.
For an in-depth discussion, tune into our episode with Dr. Büyük who is joined by Dr. Shah, as we talk about the interconnections of myofascial trigger points and CPP, and the management of neuromusculoskeletal pain and dysfunction associated with CPP.
For the PREMUS, WDPI & MYOPAIN 2023 Conference, Dr. Shah and Dr. Büyük will be hosting a 3-hour workshop titled, ‘Chronic Pelvic Pain, Central Sensitisation and Viscero-Somatic Interactions’. Dr. Büyük will also be hosting her own workshop on ‘The Assessment & Treatment of Pelvic Floor Dysfunction’ so make sure to register!
You can find all episodes of the ‘Expert Series’ on your preferred platform:
Empowering Women through Muscle and Movement
Dr. Alime Büyük's journey into understanding pelvic health started with an interest in her own sexual health and wellness. Learning about her own pelvic floor issues led her to recognise the prevalence of pelvic problems among women. Pelvic exams and treatments can be uncomfortable, especially for women who have had unpleasant experiences or where there is stigma surrounding sexual health and wellness. She found this to be the case, through her research and experience as a clinician in a town named Alanya in Turkey. Dr. Büyük found that women were suffering through years of CPP in silence, and most commonly post-pregnancy CPP. During pregnancy, the weight of the uterus tends to elongate and weaken the pelvic floor muscles. The pain and other symptoms resulting from this are often dismissed as “normal” or temporary; something that will adjust over time. Even women who suffer from CPP due to organic pathologies, such as endometriosis aren’t given the appropriate care after even surgical interventions. This is because standard medical literature suggests that once the “source of the pain” is removed, there should be no pain. CPP is one of the most common reasons for gynaecological laparoscopies and yet, women experience debilitating pain, with a reemergence of endometriosis within 2 years post-surgery. Medical encounters such as these are a few of the reasons why women refuse to seek medical help at all.
In efforts to mitigate the misconceptions surrounding CPP, Dr. Büyük underscores the importance of certain physical examinations such as palpating the pelvic floor. The pelvis consists of interconnected muscles and nerves. Through palpation, there is a better chance of identifying the myofascial trigger points that result in central sensitisation and allodynia (pain from non-painful stimuli). Myofascial Trigger Points (MTrPs) are hyper-irritable nodules that reproduce pain when engaged. Identifying where these pain spots are can help in coming up with targeted treatment plans that alleviate and manage chronic pain. Our episode with Dr. Shah and Dr. Srbely, as well as our blog on their joint research help explain MTrPs and central sensitisation in greater detail.
Learn More
Overall, Dr. Büyük emphasises the importance of empowering women, educating patients and providers, understanding the complexity of pelvic pain, and challenging traditional beliefs surrounding reproductive and sexual health. Complex and interconnected medical conditions such as CPP require comprehensive assessments, specialised care, and ongoing awareness efforts to improve the management and care.
For an in-depth discussion, tune into our episode with Dr. Büyük who is joined by Dr. Shah, as we talk about the interconnections of myofascial trigger points and CPP, and the management of neuromusculoskeletal pain and dysfunction associated with CPP.
For the PREMUS, WDPI & MYOPAIN 2023 Conference, Dr. Shah and Dr. Büyük will be hosting a 3-hour workshop titled, ‘Chronic Pelvic Pain, Central Sensitisation and Viscero-Somatic Interactions’. Dr. Büyük will also be hosting her own workshop on ‘The Assessment & Treatment of Pelvic Floor Dysfunction’ so make sure to register!
You can find all episodes of the ‘Expert Series’ on your preferred platform:
Unraveling the Complexity of Chronic Pelvic Pain with Dr. Alime Büyük
Chronic Pelvic Pain (CPP) is a persistent pain felt in the pelvic region and lower extremities of both men and women, but is experienced more commonly by women. 1 in 7 women in the United States as well as many women globally endure CPP for years before being formally and accurately diagnosed. This is because women experience pelvic pain at varying intensities and durations as well as in different locations of the body (back, abdomen, etc.,). Additionally, various comorbidities, like vaginismus and/or dysmenorrhea, often result in misdiagnoses, incorrect treatments, and ultimately, an impaired quality of life for women going through CPP. The pain just doesn’t get addressed.
To better understand, assess and manage CPP, Dr. Alime Büyük, a pelvic physiotherapist and clinical investigator, recommends a multi-pronged approach. The myofascial component of CPP is often overlooked in favour of standard medical treatments. Dr. Büyük therefore advocates for treatments that combine physical medicine, rehabilitation, and education focused on musculoskeletal pain and visceral conditions.