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Endometriosis Pain Treatment

When Endometriosis Pain Doesn’t End After Surgery

Many women are told that removing endometriosis should eliminate their pain. For some, it does. For many others, the pain continues long after surgery—even when imaging appears normal and no new endometriosis can be found. If you’ve been told ‘everything looks fine’ but you still live with pelvic pain, painful intercourse, abdominal pain, hip pain, back pain, or nerve pain, you’re not alone.

Dr. Richard Nahas evaluates chronic pelvic pain from a different perspective. Rather than focusing only on the presence of endometriosis, he looks at how previous inflammation, surgery, and scar tissue may have changed the way your nervous system functions.

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Why Can Pain Continue After Endometriosis Is Treated?

 

Endometriosis causes inflammation, and inflammation makes nerves more sensitive. Surgery can also sensitize nerves, creating scar tissue that sometimes restricts and irritates nerves and surrounding tissues. Even after endometriosis has been successfully removed, these irritable, inflamed nerves may continue sending pain signals.”

No matter how or why your pain started, eventually it changes the nervous system itself. This includes changes in all the nerves, not just the ones that hurt the most. In most cases, these changes also affect the brain and the spinal cord, which make up the central nervous system. Researchers have recognized this as a key driver of persistent pain, calling it central sensitization.

Looking Beyond the Lesions

Conventional treatment focuses on finding and removing endometriosis lesions. Dr. Nahas asks an additional question: Why is your nervous system still producing pain? And what can be done to turn it down … or turn it off?

His evaluation looks for contributors that may continue driving symptoms long after the disease itself has been treated.

Factors We Evaluate

  • Surgical scars

  • Nerve irritation

  • Fascial restrictions

  • Entrapped peripheral nerves

  • Muscle guarding

  • Persistent inflammation

  • Central sensitization

  • Previous abdominal or pelvic surgery

  • Chronic or recurrent infections

  • Mental stress and emotional trauma

Symptoms We Evaluate

  • Chronic pelvic pain

  • Pain after endometriosis surgery

  • Pain after laparoscopy

  • Painful menstrual cramps

  • Pain during intercourse

  • Pain with bowel movements

  • Pain with urination

  • Lower abdominal pain

  • Hip pain

  • Low back pain

  • Groin pain

  • Burning or nerve pain

  • Pain radiating into the legs

A Personalized Evaluation

Every patient begins with a comprehensive consultation. Dr. Nahas reviews your medical history, previous surgeries, imaging and operative reports related to endometriosis, in addition to a comprehensive history of every prior injury or trauma that may be contributing to your current condition.

 

Treatment Options

  • Neural Therapy

  • Hydrodissection

  • IV Lidocaine for central sensitization

  • Platelet-Rich Plasma (PRP)

  • Prolotherapy

  • Guided stretching

  • Scar treatment

  • Movement rehabilitation

 

 

 

 

How Neural Therapy May Help

Previous inflammation and surgery can leave nerves in a chronically irritated state. Neural Therapy uses small injections of procaine to temporarily interrupt abnormal nerve signaling with the goal of restoring healthier communication within the nervous system.

IV Lidocaine for Central Sensitization

Some women no longer hurt in just one place. Instead, their nervous system has become increasingly sensitive, leading to widespread pain, poor sleep, fatigue, and symptoms similar to fibromyalgia. By delivering the therapy to the brain, the spinal cord and the nervous system as a whole, , IV lidocaine can play a unique role in treating pain related to central sensitization.

The link between pain, stress and fertility is another reason to consider IV lidocaine. Freedom from pain can have a powerful effect on your mood, your libido, and may help you and your partner enjoy intimacy again.

Dr. Nahas has administered thousands of IV lidocaine infusions, and has developed specialized protocols that are not available anywhere else. A trial of three different infusion formulas, given about every two weeks, is the best way to find out whether this treatment is right for you – and which specific infusion gives you the best response.

While the benefits are usually not permanent, with regular treatment you can expect a major change in your pain, and a significant shift in your quality of life. Fewer pain flares, more good days, and steady improvement over time are the rule.

    Frequently Asked Questions

    Can you treat endometriosis itself?

    No. Dr. Nahas focuses on evaluating and treating the chronic pain associated with your illness, and will work in collaboration with your gynecologist who will treat the endometriosis itself.

    Can I still see my gynecologist?

    Absolutely. Treatment is designed to complement—not replace—the care you receive from your OB-GYN or endometriosis specialist.

    Do I need surgery first?

    Not necessarily. Your consultation helps determine whether your symptoms appear related to active disease, nervous system dysfunction, scar tissue, or a combination of factors. Regardless, a trial of therapy to treat your pain is usually recommended.

    I've already had excision surgery. Can you still help?

    Yes. Many patients seek consultation because pain continues after otherwise successful surgery. Whether you have had one or more ablation procedures, a total hysterectomy or any other procedure, a trial of injections or infusions to treat the pain is still an option..

    Why Dr. Nahas Takes a Different Approach

    For many women, endometriosis is only part of the story. Inflammation, surgery, scar formation, and nervous system sensitization can continue influencing pain long after the disease itself has been treated. By evaluating the nervous system—not just the pelvis—Dr. Nahas develops a personalized treatment plan focused on restoring function and improving quality of life. And because most endometriosis includes central sensitization, any woman with this illness should consider a trial of IV lidocaine.

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    Living with persistent pelvic pain can be physically and emotionally exhausting. If you’ve been searching for answers beyond medication or repeat surgery, a comprehensive evaluation may help identify factors contributing to your pain and guide a personalized treatment plan.


    Related Treatments

    • Neural Therapy
    • IV Lidocaine
    • Hydrodissection
    • Platelet-Rich Plasma (PRP)
    • Prolotherapy
    • Bone Marrow Aspirate Concentrate (BMAC)
    • BodyMap Assessment
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