Chronic Pelvic Pain, Including Endometriosis, Has New Treatment Approach Targeting Nervous System

Chronic Pelvic Pain, Including Endometriosis, Has New Treatment Approach Targeting Nervous System

An interventional pain specialist, Dr. Douglas Spiel, offers a new approach to treating chronic pelvic pain (CPP) that aims to shut down pain at its source in the nervous system, rather than through the use of conventional oral medications or creams. The approach targets the plexus of nerves connected with a pain area.

CPP affects millions of people worldwide, both men and women, and is related to diagnoses like vulvodynia, pudendal neuralgia, interstitial cystitis, prostatitis, and endometriosis.

Over time symptoms can worsen, with pain becoming more diffuse and involving several organ systems. This is a consequence of the central nervous system (CNS) responding to pain with an ‘up-regulation’ of the involved nerves, overstimulating them and eventually causing permanent damage, a condition known as neuropathic pain.

Dr. Spiel’s treatment consists of blocks directed to the plexus of nerves that serve the area, or a short-term, continuous block, lasting up to 10 days. The method leads to long-term relief, the New Jersey-based physician said in a press release, and uses Intellicath, the proprietary, patent-pending device he invented to treat nerve pain.

“An ‘up-regulated’ nervous system amplifies sensations of pain and prevents them from subsiding,” Dr. Spiel said. “Our procedure starts with a nerve block to target the overactive nerves. We know we’ve located the right nerves when the patient feels immediate relief. Guided by X-ray, we then insert the Intellicath, a specialized medical catheter or tubing that delivers a small amount of anesthetic, calming the nerves and alleviating the pain. After 7 to 10 days, we remove the Intellicath. These are minimally invasive out-patient procedures that can provide long-lasting, often permanent relief.”

CPP presents a challenge to healthcare providers due to its unclear etiology, complex natural history, and poor response to therapies. CPP is also often poorly managed, as management requires knowledge of several systems, including the musculoskeletal, neurologic, and psychiatric. Patients who suffer from CPP often complain of pain that keeps them from normal daily activities and affects their quality of life.