Q: I am a 33 years old man suffering from debilitating chronic pelvic pain in the left testicular and rectal region for the last 1.5 years. The pain started after recurrent anal fissures. I have done all tests including scrotal colour doppler/anal manometry/MRI for pelvic/semen test, etc. but everything was normal. I was diagnosed with chronic pelvic pain syndrome but there does not seem to be any cure for this. I have also gone overseas to get trigger point therapy, but the pain has not reduced. I am mostly bedridden now. I never had any medical problem prior to this. I take antidepressants (low dose) and meditate/pranayama daily to deal with the constant threat of depression due to being in bed because of pain. Only short wave diathermy over the left abdomen affords some relief for a few hours. Is there any remedy to even let me manage the pain and live? I have tried alternative therapies also. Please advise.

A:Persistent pelvic pain could be a debilitating illness. If all simple measures failed to control this, surgery or dramatic damaging procedures such as cordal injection of the spinal cord could be made. Such measures can hardly be recommended. Therefore, behaviour and moderate pharmacologic and exercise therapy should be continued as tolerated. It is assumed that neurontin and other analgesics have been tried. One final medication that sometime used is Morphine, an agent that could be damaging or surgery, which could be equally damaging. Most people who live with chronic pain have learned to disregard pain and to avoid dangerous drugs or surgery, and live a normal life. To avoid dramatic measure, patients are advised to wait until they accommodate to accepting the pain.