Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pelvic pain is a common symptom in gynecology. It may be present in acute form or in chronic form. It should be remembered that the pain is just a symptom of an underlying disorder. Whereas, it is often easy to find out the underlying cause of acute pain, it is often difficult to find out the cause of chronic pelvic pain. Sensation of pain is found to depend on many factors in an individual: e.g. subjective feel, emotional status, genetic factors, experience, gender, pain threshold, anxiety and expectations. Women have a lower pain threshold and tolerance.
NEUROPHYSIOLOGY OF PAIN
Impulse generated due to depolarization of a peripheral nerve ending (Transduction) → Transmission of the nerve impulse → Modulation (control of impulse transmission to neurons by neurotransmitters) → perception of pain.
Unlike somatic structures, which are wellrepresented in the cerebral cortex in terms of localization, visceral structures are poorly localized in the cerebral cortex. Thus, the pain arising from the pelvic organs is often localized not to the organ but referred to the skin area supplied by the same spinal nerve. Various neuromodulators(prostaglandins, endorphins) and neurotransmitters
(norepinephrine, serotonin) are involved to modify the pain sensation in the brain. Visceral pain may be due to distension, stretching, hypoxia, necrosis, chemical Irritants or inflammation of the viscera. Pelvic pain may be splanchnic or referred. One finger ‘trigger point’ tenderness is suggestive of nerve entrapment (ilioinguinal). Similarly, ‘ovarian point’ tenderness suggests pelvic congestion syndrome.
Acute Pelvic Pain: Acute pain is of short duration and generally the symptoms are proportionate to the extent of tissue damage. In chronic pelvic pain, the onset is insidious and the degree of pain is not proportionate to the extent of structural tissue damage. Most often, the basic mechanism of acute pain is due to irritation of the peritoneum by either blood or infection.
HOMOEOPATHIC MANAGEMENT OF PELVIC PAIN: -
Aesculus hip:- It works on the back and area of the lower bowel. This remedy works well for people who often experience backache and fullness in various parts of the body. There is throbbing pain in the pelvic region. Weakness in the back across the sacroiliac joint.
Pain in the left side of the ureter. Throbbing pain in the Symphysis pubis.
Arsenicum album: - A stitching type of pain in the pelvis that extends to thighs. Swelling and pain in the abdomen region. Profuse menstruation. Abdominal pain on coughing. A weak feeling in the Abdomen after urinating.
Belladonna: - Over Sensitiveness of the abdomen to clothes and touch. A cutting pain like sensation in the left side of Abdomen while coughing. A cutting pain like sensation from one side of the hip bone to the other side. Heavy periods.
Gossypium:- Pain in the ovaries that occurs at irregular intervals. Thin and water like menstrual discharge. A sensation of heaviness in the pelvic area along with backache. Delayed periods.
Agaricus:- Intense pain that is associated with a sensation of heaviness. Stomach issues along with sharp pains in the liver area. Heavy menstruation.