Endometriosis & The Nervous System: Why Pain Feels Worse Over Time

Understanding Why Endometriosis Pain Intensifies

Endometriosis is often thought of as just a reproductive health condition, but its effects go far beyond the pelvis. One of the biggest reasons pain persists or worsens over time is due to changes in the nervous system—a process known as central sensitization. This means that over time, the nervous system becomes hypersensitive to pain signals, making discomfort feel more intense and widespread, even after treatment.

If you’ve ever felt like your pain is getting worse, like even normal activities hurt more than they should, or that your body reacts strongly to even small triggers, your nervous system may be playing a role. The good news? There are ways to calm, retrain, and reset these pain pathways—and pelvic floor physical therapy can help.

How Chronic Pain Rewires the Nervous System

Pain isn’t just a physical sensation—it’s processed in the brain and nervous system. When pain from endometriosis persists over months or years, the nervous system begins to overreact to pain signals and even create pain when no active damage is present.

The Pain Alarm System Malfunctions
Think of pain like a fire alarm in your body. When endometriosis triggers inflammation, that alarm system goes off to tell your brain something is wrong. But over time, if the alarm keeps ringing without relief, your nervous system starts to react faster and more intensely to smaller and smaller triggers.

Hyper-Sensitive Nerves = More Pain, Less Tolerance
With central sensitization, the nerves that once responded only to severe pain now react to normal sensations like movement, touch, or even digestion. This is why many with endometriosis report:
✔ Pelvic pain even when they aren’t on their period
✔ Pain during sex, sitting, or even light exercise
✔ Feeling like their entire lower body is "on edge"
✔ Increased sensitivity to foods, stress, and emotions

The Brain Starts Predicting Pain—Even When It’s Not There
Once the nervous system has been trained to be on high alert, it may start anticipating pain before it even happens. This means that even when the source of pain (inflammation from endometriosis) is managed, the brain and body continue reacting as if pain is still there.

How Pelvic Floor Physical Therapy Helps “Retrain” Pain Pathways

The nervous system is highly adaptable—just as it can learn pain, it can also learn safety and relaxation. Pelvic floor therapy helps reset this pain sensitivity by:

✔ Teaching the Pelvic Floor to Relax
Chronic pain often causes pelvic floor muscles to stay tense and overactive. Manual therapy and guided relaxation help reduce protective muscle guarding, allowing for less pain and better movement.

✔ Reconnecting the Brain and Body
Nervous system retraining through breathwork, movement, and gentle touch helps the body re-learn that movement doesn’t always equal pain.

✔ Calming the “Fight or Flight” Response
Many with chronic pain live in a constant state of stress and tension (high sympathetic nervous system activity). PFPT uses vagus nerve activation, deep breathing, and positional releases to shift the body into a calmer state.

✔ Restoring Normal Sensations
Some techniques used in PFPT, like graded exposure to movement and desensitization strategies, help train the brain and nerves to stop overreacting to normal touch, movement, and pressure.

Calming Strategies for Nervous System Reset

If you experience hypersensitivity and widespread pain, try these nervous system calming techniques:

Diaphragmatic Breathing

• Inhale through the nose for 4 seconds, letting the belly expand

• Exhale slowly through pursed lips for 6-8 seconds

• Repeat for 5 minutes to activate the vagus nerve and reduce tension

Legs-Up-the-Wall Pose

• Lie on your back with legs elevated against a wall

• Focus on slow, deep breaths to release pelvic tension

• Hold for 5-10 minutes to calm the nervous system

Ready to Take Control of Your Pelvic Health?

At Renew Health in East Longmeadow, MA, we specialize in helping individuals overcome symptoms related to endometriosis such as bloating, pelvic pain, and constipation by addressing the root causes, restoring muscle balance, and providing expert guidance on movement, relaxation, and lifelong pelvic health--so you can move with confidence, feel comfortable in your body, and regain control of your well-being.

Curious if pelvic floor therapy is right for you? Fill out our contact form to chat with one of our pelvic health specialists!

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📍 Renew Health – East Longmeadow, MA

FAQs

Q: Why does endometriosis pain continue even after surgery?
Because your nervous system may have become hypersensitive to pain, even after the inflammation is managed—a process called central sensitization.

Q: Can pelvic floor therapy help nerve pain from endometriosis?
Yes. Pelvic floor therapy can help calm overactive nerves, reduce muscle guarding, and retrain pain pathways.