The development and efficacy of an interdisciplinary chronic pelvic pain program

Abstract

Introduction: Chronic pelvic pain (CPP) is a significant issue, and approximately 14% of women experience CPP once in their lifetime. While interdisciplinary pain management is considered the gold standard of treatment, few programs offer this type of treatment in Canada. The aims of this paper were to: 1) describe the development of an interdisciplinary CPP program; and 2) demonstrate changes in patient-related outcomes after attending an interdisciplinary CPP program.
 Methods: Referrals were received from community urologists and obstetricians/gynecologists, and pain physicians at the Michael G. DeGroote Pain Clinic. Patients attended an orientation session, completed an interdisciplinary assessment, and if appropriate attended an eight-day interdisciplinary CPP program. Each day consisted of group-based pelvic floor physiotherapy, psycho-education, goal-setting, cognitive behavioral therapy, and mindfulness. Psychometric questionnaires were completed pre- and post-program by patients, and paired sample t-tests were used to evaluate the changes in patient-related outcomes after attending the program.
 Results: Thirty-seven female patients completed the program, and results demonstrate that the CPP program was associated with significant improvements in impact of pelvic pain on quality of life, readiness for change, and pain-related self-efficacy, as well as decreases in pain catastrophizing and fear of pain/re-injury.
 Conclusions: CPP is a complex condition that requires interdisciplinary management and care. The results of this study demonstrate the short-term benefits of an interdisciplinary CPP program and highlight the unique needs of women with CPP and implicate multiple factors for programming and treatment.

Does group physiotherapy improve pain scores and reduce the impact of pelvic pain for women referred with persistent pelvic pain? A clinical trial

“…Despite self-selection, a number of women did not start/did not finish T3, although those who did finish this treatment arm returned significant clinical gains. In a study by Katz et al, 33 women were carefully selected and enrolled in an interdisciplinary group programme, completing 24 h of therapy over 8 weeks, and this programme demonstrated 91% attendance data (completing at least 15 h of the programme) and clinical gains over the course of the programme. Further refinement of the group exercise programme may be considered in the future.…”

Physiotherapeutic assessment and management of chronic pelvic pain syndrome

“…[ 6 ] According to Katz et al, diagnoses made in collaboration between a larger number of specialists will tend to eliminate the possibility of diagnostic mistakes and may result in faster recovery times. [ 7 ] Physiotherapy is one of the conservative treatment form in therapy of the chronic pelvic pain syndrome, which aim is a regulation of tension in the pelvic floor muscles and lumbopelvic hip complex, elimination of the myofascial trigger points. Moreover, the therapy of spinal and peripheral joints in the pelvis area is recommended.…”

The role of psychosocial factors in the interprofessional management of women with chronic pelvic pain: A systematic review

“…27 Four studies [25][26][27][28] included measurements for either painrelated fear or anxiety or generalized anxiety. Statistical significance was only reported in the studies from Ariza-Mateos et al and Katz et al 25,27 Generalized anxiety was reduced in both the intervention and the control group after the intervention compared with the baseline; nonetheless, group differences were not reported. 26 Pain-related fear or anxiety could be reduced in three studies 25,27,28 comparing after treatment measures with baseline, with significant mean changes according to Katz et al 27 Although both the combination of graded exposure with manual therapy and manual therapy alone resulted in significant changes in fear-avoidance beliefs, the measurements in the booklet control group did not yield significant measurements.…”