The Pain Closet

In retrospect, that I gravitated toward and then chose recreational cycling as one of the primary avocations of my adult life isn’t really that surprising because I have been trafficking in pain my entire life.

To be a cyclist is to manage pain; to be an elite cyclist is to embrace, even scoff at, pain.

Although I did not make the association for the vast majority of my life, I have been navigating chronic pain and anxiety since my earliest memories as a child.

About 20 years ago, I was forced to admit my clinical anxiety, and depression. But the chronic pelvic pain that the anxiety has cultivated for all of my life has never been adequately addressed — mostly because the medical community has failed me.

I am currently rededicating myself to self-care, to addressing my anxiety and chronic pain. Part of that has been in recent years trying to manage on my own what has been identified by Wise and Anderson (and others) as pelvic pain commonly, and in my case, misdiagnosed as prostatitis (singularly as an infection requiring antibiotics).

As part of my journey, I have discovered that the awareness of anxiety and pelvic pain has greatly expanded in recent years, Wise and Anderson publishing a definitive volume of their work as well as many sufferers now sharing their stories and self-care online.

One set of videos (see this one as an entry point), in fact, includes comments from sufferers, mostly men and many in their 20s, that nearly pushed me to tears; their stories are my story repeated over and over, filled with pain, depression, and hopelessness — and embarrassment.

In my 20s, newly married and starting a life that included plans to have a child, I experienced groin pain one day while sitting in the barber shop. The pain was acute and triggered my anxiousness, my tendency toward hypochondria.

This pain led me to my family doctor, and then a urologist.

For several years, after being diagnosed with prostatitis, I regularly visited that urologist and experienced the same pattern of debilitating pain associated with my lower back, groin and pelvis, and all of my bodily functions (including sexual discomfort).

Each visit to the urologist also followed the same pattern: The urologist would acknowledge my pain and symptoms, admit that the repeated screenings revealed no sign of infection in my prostate, explain (again and again) that prostatitis often is hard to diagnose or treat because the infection routinely cannot be identified, and then prescribe (again and again) extended doses of antibiotics, which never impacted the pain or symptoms in any way but had side effects.

Finally, as I approached my late 20s, I discussed this futility with the urologist, and we decided that simply living with the pain posed no real threat to me since he could never find any real sign of infection. So I simply quit going to the urologist and suffered [1].

Silently.

Closeted in pain that was embarrassing because it impacted necessary bodily functions and cloaked my ability to have normal sexual pleasure.

It would be a decade before I realized I had clinical anxiety, panic attacks, and depression, but it was a couple decades before I discovered the work of Dr. David Wise, who had come to treat his own pelvic pain.

The work and book published by Wise and Dr. Rodney Anderson are a damning indictment of the medical profession, seemingly blinded by assumptions about disease (a physical phenomenon) and treatment (bound by pharmaceutical constraints) [2].

Anxiety, in fact, creates a wide range of pelvic pain that has been misdiagnosed and treated incorrectly for decades (see Symptoms & Treatments links, for example).

Since the Wise/Anderson diagnosis and treatments are rare in the field of urology and even within mental health treatment and physical therapy (I have brought the information to a PT, in fact, who had never heard of the condition or the treatments), however, being aware of my conditions and the relationship between anxiety and chronic pain has not really led to any sort of better quality of life.

To my resignation in my late 20s I have simply added some new knowledge.

Wise/Anderson practice on the West coast and require an extended and expensive commitment of time (and probably will not be covered by traditional insurance).

This tiny ray of hope has turned, for me, always into yet more depression and greater fatalism.

A doubling and tripling down on what I know best — leaning into and living with and through chronic pain, and the concurrent embarrassment.

Being skeptical by nature, and prone to cynicism, I must admit that discovering the 2018 edition of the Wise/Anderson book and what seems to be a growing online community of sufferers, many who are having success with self-care, has spurred a new sense of hope.

I have modified the stretching routine one PT developed for me by looking at the Wise/Anderson book, added new stretching and trigger point massages based on the online videos by sufferers who also have been inspired by Wise/Anderson’s work, and begun to think more intentionally about how to move beyond the chronic pain instead of simply embracing and suffering with it.

Chronic pelvic pain and anxiety are evil twins because they create and are fed by the fretting and embarrassment that they foster in those of us prone to anxiety.

But having mental and physical conditions recognized and treatable only outside mainstream medicine is a really cruel reality.

I watch and hear, for example, dozens of commercials for anxiety/depression medications, ED medications, and the never-ending promises of herbal solutions to prostate dysfunction.

For me, and many others I have discovered online, these are all tremendous wastes of time and money.

Since anxiety/depression, sexual dysfunction, and prostatitis are big money for the pharmaceutical and medical professions, those of us outside this mainstream approach are left in our closet of pain while grey-haired but smiling men on TV lounge in bath tubs outdoors beside their not-so-subtly younger women partners lounging beside them in their bath tubs, hands joined for the TV audience being promised sexual paradise in a pill.

So I am left here in middle age, a small ray of hope sitting beside some anger, anger I will need to work through as I seek ways to move beyond anxiety and chronic pain instead of resigning myself to this as my life as I did in my 20s.

[1] See this blog post:

Added to an individual’s anxiety is the puzzlement of the doctors. The doctor is often frustrated about his inability to help the problem and is not infrequently worried that perhaps he has missed something. Doctors are problem solvers. As we have discussed in our book and other essays, certain doctors do not respond well to their own helplessness to solve the problem of chronic pelvic pain syndromes. Any anxiety, uncertainty or helplessness felt by the doctor is almost always communicated to the patient — a communication whose impact can be overwhelmingly upsetting to the patient.

[2] See this blog post:

Unfortunately, the historical treatment of pelvic pain has almost entirely been a misdirected physical treatment of the organs of the pelvis such as the prostate or bladder. Indeed, the conventional medical establishment unfortunately continues to place most of the blame for pelvic pain on the pelvic organs, and attempts to throw various pharmaceuticals at the condition, including antibiotics, anti-inflammatories, botox, and other classes of medications, as well as procedures such as nerve blocks and even surgery, all of which have had, at best, mixed results. And, when physical therapy for the pelvic muscles is prescribed, it is almost always prescribed alone, that is, with no accompanying psychological/cognitive support, relaxation training, or self-treatment training.