You Are Not Alone

Living with chronic pelvic pain can feel isolating, confusing, and deeply frustrating. The persistent discomfort—whether it’s aching, burning, sharp pain, pressure, or pain related to intimacy, bladder, or bowel function—can significantly impact your quality of life, relationships, and sense of self. Many patients in Los Angeles feel unheard or struggle to find answers.

At Body and Mind Pain Center, Dr. Zev Nevo offers a different path. We provide a compassionate, validating, and safe space to explore the complexities of your pelvic pain. Dr. Nevo utilizes a comprehensive, evidence-based, and patient-centered approach, recognizing that pelvic pain often stems from multiple interconnected factors. Our goal is not just symptom relief, but true healing and restoration of function, helping you find Relief to Relive.

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Understanding Chronic Pelvic Pain: Symptoms, Causes & Specific Conditions

Chronic pelvic pain (CPP) is generally defined as pain below the belly button and between the hips lasting six months or longer. It’s not a single diagnosis but a complex condition with diverse presentations.

Common Symptoms May Include:

  • Pain described as dull aching, sharp stabbing, burning, cramping, or pressure.
  • Pain located in the lower abdomen, pelvis, genitals (vulvodynia), tailbone (coccydynia), rectum, or lower back/hips.
  • Pain during or after sexual intercourse (dyspareunia).
  • Pain with urination or bowel movements.
  • Urinary urgency, frequency, or bladder pain (symptoms similar to Interstitial Cystitis/Bladder Pain Syndrome).
  • Bowel issues like constipation, diarrhea, or bloating (often overlapping with IBS).
  • Pain worsened by sitting, standing, or specific activities.

Potential Contributing Factors We Investigate:

  • Chronic pelvic pain rarely has a single cause. Dr. Nevo investigates multiple potential contributors relevant to pelvic pain treatment in Los Angeles:
  • Musculoskeletal Issues: Pelvic floor muscle dysfunction (often hypertonicity/tightness with trigger points), sacroiliac (SI) joint dysfunction, hip or lower back problems, fascial restrictions, postural imbalances, issues related to hypermobility syndromes (e.g., EDS).
  • Neurological Factors: Nerve irritation or entrapment (like sensitivity involving the pudendal nerve), central sensitization (where the nervous system becomes amplified and interprets normal signals as painful – a form of neuroplastic pain).
  • Visceral Contributions: Overlap with conditions like Irritable Bowel Syndrome (IBS) or Bladder Pain Syndrome/Interstitial Cystitis (IC/BPS), where gut health or bladder sensitivity plays a role.
  • Systemic Factors: Chronic inflammation, hormonal influences (related to conditions like endometriosis pain or menstrual cycles), or autoimmune processes investigated via Functional Medicine.
  • Psychosocial Influences: The profound impact of chronic stress, anxiety, depression, or past trauma on nervous system regulation and pain perception.

Addressing Painful Periods (Primary Dysmenorrhea):

Many women experience painful periods (dysmenorrhea) without underlying pathology. This pain, often sharp or cramping in the lower abdomen radiating to the back/thighs, is typically linked to increased prostaglandins causing uterine contractions and reduced blood flow. Standard treatments often rely heavily on NSAIDs or hormonal methods. At Body and Mind Pain Center, Dr. Nevo offers an effective, novel protocol for primary dysmenorrhea that combines targeted therapies:

  • Osteopathic Manipulative Medicine (OMM): Gentle techniques address pelvic, sacral, and lumbar alignment and reduce muscular/fascial tension contributing to cramps and restricted blood flow.
  • Extracorporeal Shock Wave Therapy (ESWT): Based on protocols shown to be effective, targeted shockwave therapy is applied to specific myofascial points in the lower abdomen and back during the first few days of symptoms. This novel approach aims to reduce muscle spasm, improve local circulation, and decrease pain sensitivity, offering significant relief.

Our Integrative Approach to Pelvic Pain in Los Angeles:

Recognizing the multifaceted nature of CPP, Dr. Zev Nevo employs a unique combination of diagnostic tools and therapies from both our Medical and Wellness Clinics, tailored to your specific findings and goals:

  • Comprehensive Evaluation: Starts with deep listening, validating your story, and a specialized physical exam (including osteopathic assessment).
  • Advanced Diagnostics: Utilizing Diagnostic Musculoskeletal Ultrasound Los Angeles to visualize muscles, nerves, and joints contributing to pain. Functional Medicine testing  may explore systemic factors (gut, hormones, inflammation).
  • Osteopathic Manipulative Medicine (OMT): Gentle, hands-on techniques to address pelvic alignment, SI joint mechanics, fascial restrictions, release external muscle tension (including related pelvic floor areas), calm the nervous system, and improve visceral mobility. This forms a cornerstone of our approach, often used in novel combination therapy with ESWT.
  • Extracorporeal Shock Wave Therapy (ESWT): Targeted shockwave application to address specific myofascial trigger points, fascial restrictions, or areas identified during examination (as described in our dysmenorrhea protocol), often providing significant relief when combined synergistically with OMT.
  • Ultrasound-Guided Interventions: Precise, targeted injections using real-time ultrasound for: Trigger points (pelvic floor/hip rotators), nerve hydrodissection, SI joint injections, potentially regenerative injections  for related ligaments (especially relevant in hypermobility).
  • Mind-Body Rehabilitation: Essential for addressing the nervous system component. Includes: PRT for central sensitization/neuroplastic pain, SSP / HeartMath for nervous system regulation, Polyvagal-informed techniques, EAET, IFS concepts, and somatic approaches to process trauma/stress.
  • Functional Medicine Support: Addressing gut health (IBS), nutritional factors, hormonal balance, and inflammation through personalized plans via our Wellness Clinic.

Patient Empowerment & Restoring Quality of Life:

Our approach focuses on empowering you with understanding about your specific pain contributors. We work collaboratively to set realistic goals focused on improving function – whether that’s sitting comfortably, enjoying intimacy, returning to exercise, or simply navigating daily life with less pain and more autonomy. Consistent with our fiduciary care model, you will be fully informed about all evidence-based options.

The Body and Mind Pain Center Difference:

Finding comprehensive, integrated care for chronic pelvic pain in Los Angeles can be challenging. Dr. Zev Nevo offers a rare combination of expertise under one roof:

  • Advanced PM&R and Osteopathic skills for musculoskeletal diagnosis and treatment.
  • Expertise in diagnostic and interventional ultrasound for precision targeting.
  • Novel combination therapies, such as OMT paired with ESWT for enhanced results.
  • Deep understanding of Mind-Body Medicine and Pain Neuroscience (including PRT) to address nervous system sensitization.
  • Functional Medicine perspective to investigate underlying systemic factors.
  • All delivered with compassion, validation, and patient-centered, evidence-based, fiduciary care.

This integrated model allows for truly personalized and holistic treatment plans designed for lasting relief and improved quality of life.

Frequently Asked Questions:

What types of pelvic pain do you treat (including dysmenorrhea)?

Dr. Nevo treats a wide range of chronic pelvic pain conditions in Los Angeles, addressing pain stemming from musculoskeletal sources (muscles like the pelvic floor, fascia, joints like the SI joint), neurological factors (nerve irritation, central sensitization/neuroplastic pain), and considering overlaps with visceral conditions (like IBS or bladder sensitivity). He also has specific experience managing pain associated with hypermobility/EDS and offers an effective protocol for primary dysmenorrhea (painful periods without underlying disease).

How can OMT help pelvic pain and dysmenorrhea?

Osteopathic Manipulative Treatment (OMT) uses gentle, hands-on techniques. For pelvic pain and dysmenorrhea, it can help by assessing and treating imbalances in the pelvis, sacrum, and lower back alignment; releasing tension in related muscles (including externally accessible pelvic floor attachments) and fascia; improving lymphatic drainage and blood flow; and calming the nervous system – all factors that can contribute significantly to pelvic pain and menstrual cramps.

How is Shockwave Therapy (ESWT) used for pelvic pain or period pain?

ESWT uses focused acoustic waves. For certain types of pelvic or period pain, Dr. Nevo applies it precisely to identified myofascial trigger points or areas of tissue restriction (often in the lower abdomen, back, or hip muscles) that contribute to pain referral patterns or dysfunction. This can help reduce muscle spasm, improve local circulation, and modulate pain signals. At our Los Angeles clinic, we often find it particularly effective when used as part of a novel combination therapy with OMT.

What can ultrasound show for pelvic pain?

Musculoskeletal ultrasound provides real-time visualization of soft tissues without radiation. For pelvic pain, Dr. Nevo uses it to assess muscles (e.g., identifying trigger points or tears in hip rotators or abdominal muscles), tendons, ligaments (around the SI joint or hips), and nerves (looking for signs of irritation or entrapment points). It is crucial for accurately guiding injections to these specific structures if needed.

How does the nervous system / brain contribute to pelvic pain?

Your nervous system acts like an alarm system. In chronic pelvic pain, this system can become overly sensitive (central sensitization), causing the brain to interpret even normal signals from the pelvis as dangerous or painful. This is often called neuroplastic pain. Stress, fear, and past trauma can further heighten this sensitivity. Mind-body therapies help retrain these brain pathways and calm the nervous system’s alarm response.

Can stress or trauma make pelvic pain worse?

Absolutely. Stress and trauma activate the body’s “fight-or-flight” response, leading to increased muscle tension (often unconsciously clenching pelvic floor/hip muscles), heightened inflammation, changes in gut function, and an upregulated nervous system that is more sensitive to pain. This creates a cycle where stress worsens pain, and pain causes more stress. Creating a sense of safety (co-regulation) is key to breaking this cycle.

What is central sensitization / neuroplastic pain?

Central sensitization means the central nervous system (brain and spinal cord) has become persistently hypersensitive and amplifies pain signals. Neuroplastic pain is real pain that is primarily driven by these sensitized brain pathways, rather than ongoing significant tissue damage in the pelvic region. The hopeful news is that because it’s learned (“neuroplastic”), these pathways can often be retrained with therapies like PRT.

How do functional medicine approaches help pelvic conditions?

Functional Medicine looks for underlying systemic issues that can contribute to pelvic pain. This might involve investigating and addressing gut health imbalances (inflammation, microbiome disruptions often seen with IBS), identifying and correcting hormonal imbalances (which can influence conditions like endometriosis pain or dysmenorrhea), optimizing nutrient status for tissue repair and nerve health, and reducing overall systemic inflammation – factors often overlooked in conventional approaches.

What is the first step to getting help at your Los Angeles clinic?

The first step is to schedule an initial consultation with Dr. Zev Nevo. You can call our Los Angeles office at [Phone Number] or use our online contact/scheduling form. Our staff can help determine if the Medical Clinic or Wellness Clinic is the best starting point. Please complete the secure New Patient Intake Form online before your visit.

Is treatment typically covered by insurance?

Insurance coverage for integrative pelvic pain care in Los Angeles varies widely. Some medical services like consultations, OMT, or diagnostic ultrasound may be covered or reimbursable depending on your specific plan. However, many specialized therapies (ESWT for certain diagnoses, specific mind-body interventions like PRT or SSP coaching, Functional Medicine testing/consults) are often out-of-pocket expenses. We are committed to transparency and will provide you with a superbill for services rendered that you can submit to your insurance for potential out-of-network reimbursement. We strongly advise verifying your benefits directly with your insurance provider.

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