The amount of danger signals that are sent up to the brain
The level of threat that is perceived by the brain
= The amount of pain we experience
In the context of chronic pelvic pain, the brain either perceives safety or danger. The more it perceives danger, the more pain we experience. It is important to note that chronic pain is not prolonged acute pain. "Chronic Pain" is the result of our brain interpreting signals through our nervous system, commonly long after the actual tissue damage has healed.
Triggers of these signals in the pelvic region can include one or more of the following:
1. Functional Systems (bladder, bowel, uterus, prostate in male pelvic pain)
2. Structural Systems (muscles and ligaments, often in spasm)
3. Nerves firing (causing tingling, burning, itching, dryness, aching, or even stabbing of surface tissues)
All of the signals from these triggers add up in our memories, emotions, and thoughts. These signals are also called "generators". When generators are sent up to the brain, the brain responds by sending down corresponding inhibitors. For example, when we stub our toe it really hurts for a couple of seconds! Until our inhibitors take over. Our brain immediately tells us that by all of our previous experiences, stubbing our toe is not dangerous. So the pain quickly fades away.
But with chronic pain, the generators outweigh the inhibitors and the volume of our nervous system gets "turned up". Over time, the nervous system responds more and more strongly to a smaller amount of signals. This is one reason why sensitivity related to the external genitals and pelvic floor, for example, can increase over time when not treated and managed properly.
The more we understand what is going on in the body, how pain is processed, and the more "tools" we have to temper these signals and how they are reacted to in the brain, the more we are likely to reduce the pain or "turn the volume dial down". Focused training can help us guide us in the process. These tools include: Mindfulness-Based Stress Reduction, diaphragmatic breathing techniques, and physical therapy. As well as other disciplines like medicine, psychological counseling, nutrition and dietary changes, yoga, and massage.