Flare ups in Chronic Pelvic Pain Syndrome/CPPS can be particularly troubling and worrisome for the patient. As someone who has suffered with chronic and acute pelvic pain I know only too well how much they can throw you off course. As a therapist I see many patients suffer horribly with flare ups. They can grate you to the very core of your being. They can darken your mood, outlook, approach to recovery, even your willingness to carry on. They bruise relationships and confidence in self. They can, however be beneficial! If you are in the middle of a flare this can be hard to hear, I know this only too well myself. But, we can use a flare up to gauge how much we need to adapt our lifestyles accordingly. Check out my mini presentation on how to manage flare ups here.
Getting to the root of flare ups can be incredibly beneficial in terms of recovery. The longer a patient is away from a flare up the more normality they can instil back in their life. These longer periods without flares can provide the patient with the resources needed for recovery. Conversely, being in continuous flare ups can deplete a patient of resources and send him back to square one again.
Do you know what causes your flare ups? According to a research article released in April 2018 there are common triggers for flares. The following list was identified by patient focus and think groups:
- Physical activities
- Sedentary behaviours
- Diet
- Stress
- Sexual activities
- Allergy symptoms
- Infection
The research paper was a longitudinal study to evaluate a range of patient reported triggers. The study took place over the period of a year. It included male and female patients but I have only used the results of the male participants in this blog. 116 men were assessed through an extensive battery of questionnaires at bi-annual clinic visits and a brief set of bi-weekly online assessments. Each male participant was asked about the onset of their flare up including:
- Duration
- Intensity
- Symptoms
- Beliefs about their current flare up triggers
For males suffering with Urological Chronic Pelvic Pain Syndrome (UCPPS) the only statistically significant flare up trigger was ‘Any sexual activity” and sex with a “New sexual partner.” If you are a patient reading this then I would be confident in saying you are most likely to have had a flare up after sex at some point in the history of your case. I can say with confidence that it is the most common flare up trigger in my patient population. And, I know myself that I too have had flare ups caused by sexual activity too.
Although “sexual activity” and a “new sexual partner” were the only statistically significant findings for males in this paper it doesn’t tell the full story. It was concluded that many of the participants would have their own individual flare up triggers. That those identified in the focus groups above perhaps didn’t cover the individualistic natures of participants. Meaning that we are all individuals and that a trigger for one, may not be a trigger for another. This is also common place in my practice.
MAPP are the Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain and are leading some of the most cutting edge research into these conditions at present. Their research paper “A Case-Crossover Study of Urological Chronic Pelvic Pain Syndrome Flare Triggers in the MAPP Research Network” was one of 2 papers released this year on flare ups and flare up management. Management and avoidance of flare ups is imperative for a successful, less fractious recovery. I hope that MAPP continue to carry out ground breaking research into flare ups and their triggers.
I take a great deal of time to identify unique triggers for my patients and then workout a strategy to reduce and avoid flare ups. For more details one how to manage your own flare ups, reduce their impact, gain control and start formulating a plan that will reduce the impact on your life please feel free to contact The Pelvic Pain Clinic. Knowledge is power in getting over pelvic pain. Be the driver in your recovery, not just a passenger