#Endometriosis: Pain Relief And Pain Management Options.

The main symptom of endometriosis is pelvic pain - there are various pain relief and pain management options available.
Read More about Causes and Symptoms of Endometriosis

Pain relief and pain management options.

Heat and comfortA simple hot water bottle or hot bath may help to reduce pain. Some women also find heated wheat bags to be effective. Reducing stress will also be beneficial.

Painkillers:NSAIDs such as Ibuprofen, Voltarol and Ponstan (mefanemic acid) block the production of prostaglandins in the body. Prostaglandins occur naturally, in response to injury or disease, and cause pain and inflammation.  They have a number of functions including making the womb contract during a period (which helps with the shedding of the womb lining). These contractions can cause pain. It is thought that women with endometriosis may produce more prostaglandins than women without the condition.
NSAIDs only work effectively if they are taken before the body produces prostaglandins. Many people take NSAIDs as they would other painkillers such as paracetamol. It is best to start taking NSAIDs the day before, or several days before, a period or pain is expected. Common side effects of NSAIDs include nausea, vomiting, diarrhoea, stomach upsets and stomach ulcers. These side effects can be reduced by taking the drugs with food or milk.
Codeine
Codeine-based painkillers are effective painkillers but can cause constipation and gastro-intestinal upset, which may aggravate symptoms in women with endometriosis.
AnalgesicsSimple analgesics such as paracetamol can be used to treat mild pain.        

Physiotherapy
Physiotherapists can develop a programme of exercise and relaxation techniques designed to help strengthen pelvic floor muscles, reduce pain, and manage stress and anxiety. After surgery, rehabilitation in the form of gentle exercises, yoga, or Pilates can help the body get back into shape by strengthening compromised abdominal and back muscles.

Pain modifiersThese drugs work by altering the body’s perception of pain. Tricyclic anti-depressants (example – Amitriptyline) are drugs that are mainly used to treat depression but have been found to have an effect on the nervous system and the way the body manages pain.  The pain messages travel through the body’s central nervous system, but these drugs can help to stop those messages from reaching the brain.

Transcutaneous Electrical Nerve Stimulator (TENS) machines
TENS machines are an alternative to pain killers.  They are small, unobtrusive machines with electrodes that attach to the skin and send electrical pulses into the body. This does not hurt but instead feels mildly ticklish. The electrical pulses are thought to work by either blocking the pain messages as they travel through the nerves or by helping the body produce endorphins which are natural pain-fighters. Some TENS machines can be clipped to a belt. Contact your doctor before using a TENS machine as they are not suitable for those who may be pregnant or who have a heart condition.

 How Diet May Affect Endometriosis
“Women with endometriosis should avoid fatty foods, such as red meat and [high-fat] dairy foods that may be high in polychlorinated Biphenyls (PCBs) and dioxins, to reduce their exposure to these estrogenic pesticides,”. Use organic food whenever feasible, peel fruits and vegetables. Some research suggests a link between dioxins in the environment and increased levels of estrogen.
Additional research found that a lack of antioxidants may contribute to endometriosis, while absorbing key antioxidant nutrients like selenium and vitamins A, C, and E may help keep it under control. 

Eat a high fiber diet that includes plenty of fruits, vegetables, beans, whole grains, and nuts
Limit saturated fat by eating mostly plant–based foods, choosing low–fat dairy products, and selecting lean meats
Eat more sources of omega–3 fats such as fatty fish (salmon, mackerel, herring, and sardines), fish oil, canola oil, flaxseeds, walnuts, and pumpkin seeds.
Eating a balanced diet with lots of fruits and vegetables, whole grains, plant–based protein, lean meats, and healthy fats can help you get all of the vitamins, minerals, and other nutrients you need to keep your immune system and body healthy.
If you eat three nutritious meals a day and healthy snacks which include a variety of fruits and vegetables, protein, dairy foods, and whole grains, you are probably getting enough of most vitamins and minerals through the food you eat. If you aren’t getting in all of your food groups on a regular basis, you may want to consider taking a daily multivitamin so you will get the total amount of nutrients that your body needs. Talk to your health care provider (HCP) to see if you should take a multivitamin or other dietary supplement.

jeanhailes.org.au, endometriosis-uk.org, gazettereview.com, medicalnewstoday.com, everydayhealth.com