What's new in managing pelvic pain ?

What's new in managing pelvic pain ?

I attended the Convergences PP congress in Nimes recently. There were several interesting presentations including the results of the nerve block trial carried out by several pain teams in France.

The results show that diagnostic blocks are still important but that therapeutic nerve blocks with steroids are not of long term benefit in the majority of patients.

There were several presentations about Botulinum Toxin A and also a capsaicin patch ( the latter for post-operative pain ) lasting for several weeks.

Two patient representatives, Francoise Watel and I did a session on "Supporting patients with pelvic pain " ( picture attached ) There was also a meeting of pelvic pain patient reps from several European countries at which I spoke about the pelvic pain meeting that the Pelvic Pain Support Network hosted in London in March and also about Pain Alliance Europe and the Societal Impact of Pain.

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  • Is the Capsaicin patch a type of medication? What does the botolinum do, and do the doctors in Nantes use it?

    Interesting about the nerve blocks with steroids, as the pain specialists in London seem to see them as a long-term pain management treatment.

  • Yes, Capsacin is made from chilli peppers ( the strongest variety ). It has been used for some time in a topical cream form and it's properties for relieving pain have been known for centuries. It creates a burning sensation, so can't be used in areas where there are mucous membranes. The butt is a difficult area as it's curved, so I'm not sure it would stay in place but I'm going to contact the person who did the presentation to find out more.

    They have used Botox A in Nantes ( in fact I had it done there several years ago ) They did a preliminary trial using it. There is currently a trial in several centres in France led by Nantes for Botox in anal pain.

    It will be interesting to see the impact of the nerve block trial.

  • Thanks Judy,

    I have had a steroid block, two in fact and they did nothing long term as that report suggested. I also had a Botox shot, into my piriformis muscle and while it didn't do a great deal for the nerve (sciatic/pudendal and possibly post femoral cutaneous) issues, possibly because of too much scar tissue there, the muscle itself was so much less painful. That effect lasted for quite a few months too.

    The Capsacin patches sound rather interesting.

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