Advances in Treatment of Chronic Pelvic Pain

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Millions of people, both women and men, suffer from chronic pelvic pain. Patients complain of relentless pain that interferes with daily activities and relationships. They have usually seen several physicians in different specialties, hoping to find the cause of the pain so they can get some relief. Unfortunately, that is not often the case. Most patients undergo extensive diagnostic workup, including procedures or surgery, and are diagnosed with one or more medical conditions, but few are offered treatment to relieve the pain.

Dr. Douglas Spiel, an Interventional Pain Specialist in New Jersey, offers treatment directed at the pain and dysfunction associated with diagnoses such as vulvodynia, interstitial cystitis, pudendal neuralgia, endometriosis, and prostatitis. His treatment is not conventional oral medications and creams, but rather, treatment directed at shutting down the source of the pain from the nervous system by targeting the plexus of nerves associated with the area of pain.

Many of these patients have been suffering for years searching for a solution. They have commonly undergone procedures and surgery in an attempt to improve their symptoms, offering partial or temporary improvement, at best. Over time they report worsened symptoms and describe the pain as a more diffuse, “spreading” pain involving multiple organs systems in the area. It is quickly obvious that all of the organ
systems aren’t causing the pain. The nervous system is responding to the chronic pain with an “upregulation” of the involved nerves, resulting in prolonged stimulation of the affected nerves, which cannot return to their normal state.iStock_000010100054XSmall

We now know that the pain is not originating from the involved organs, but rather the nervous systems itself. This is known as neuropathic pain. The good news for patients is that breakthroughs in treating the neurological source of the pain can bring long-lasting relief. Treatment may consist of blocks directed to the plexus of nerves that serves the area, or may involve a short term, continuous block lasting 7 to 10 days, which results in long term relief.

Dr. Spiel has pioneered the technique of “down-regulating” the malfunctioning nervous system to interrupt the transmission of pain impulses and calm the nerves that are causing pain. He is the inventor of the Intellicath™, a proprietary, patent-pending device that opens new avenues in treating nerve pain. “An ‘up-regulated’ nervous system amplifies sensations of pain and prevents them from subsiding,” he explains. “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.”

For additional information, visit or call Dr. Spiel’s office at 732-548-2000.