scholarly journals The development and efficacy of an interdisciplinary chronic pelvic pain program

2020 ◽  
Vol 15 (6) ◽  
Author(s):  
Laura Katz ◽  
Adria Fransson ◽  
Lisa Patterson
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Pain Catastrophizing ◽  
Behavioral Therapy ◽  
Readiness For Change ◽  
Pain Clinic ◽  
Interdisciplinary Management ◽  
Interdisciplinary Pain Management ◽  
Orientation Session ◽  
Interdisciplinary Assessment

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.

Effectiveness of an interdisciplinary pain management program for the treatment of chronic pelvic pain

Pain ◽  
1990 ◽  
Vol 41 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Linda D. Kames ◽  
Andrea J. Rapkin ◽  
Bruce D. Naliboff ◽  
Simin Afifi ◽  
Theresa Ferrer-Brechner
Keyword(s):  
Pain Management ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Management Program ◽  
Pain Management Program ◽  
Interdisciplinary Pain Management

Cognitive behavioral therapy for the treatment of chronic pelvic pain

2020 ◽  
Vol 34 (3) ◽  
pp. 409-426
Author(s):  
Ivan Urits ◽  
Jessica Callan ◽  
Warner C. Moore ◽  
Mitchell C. Fuller ◽  
Jordan S. Renschler ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Behavioral Therapy ◽  
Cognitive Behavioral

Fibromyalgia Phenotype in Chronic Pelvic Pain Patients Presenting to a Tertiary Care Pain Clinic [3Q]

2016 ◽  
Vol 127 ◽  
pp. 140S
Author(s):  
Tara A. Gallagher ◽  
Samantha Abdallah ◽  
Sawsan As-Sanie ◽  
Nichole Mahnert
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Tertiary Care ◽  
Pain Clinic ◽  
Pain Patients

Pain catastrophizing is associated with pain thresholds for heat, cold and pressure in women with chronic pelvic pain

2020 ◽  
Vol 20 (3) ◽  
pp. 635-646
Author(s):  
Hanna Grundström ◽  
Britt Larsson ◽  
Lars Arendt-Nielsen ◽  
Björn Gerdle ◽  
Preben Kjølhede
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Pain Sensitivity ◽  
Group Membership ◽  
Pain Catastrophizing ◽  
Partial Least Square ◽  
The Body ◽  
Psychological Variables ◽  
Psychological Traits ◽  
Pain Thresholds

AbstractBackground and aimsPsychological traits such as pain catastrophizing may play a role in the development of chronic pelvic pain (CPP). Pain catastrophizing is the tendency to amplify negative cognitive and emotional pain processes. The Pain Catastrophizing Scale (PCS) assesses elements of pain catastrophizing divided into three subgroups of factors (rumination, helplessness and magnification). Previous studies have shown associations between CPP and increased pain sensitivity, widespread generalized hyperalgesia, and decreased pain thresholds, but the relation between pain catastrophizing and specific pain thresholds has not yet been widely examined in this patient group. The aims of this study were (a) to determine if catastrophizing is increased in women with CPP compared with pain-free women, (b) to assess the importance of pain catastrophizing, psychological distress variables, and subjective pain sensitivity for pain thresholds of heat, cold and pressure in these two groups, and (c) to determine whether psychological variables or pain thresholds best contribute to the differentiation between CPP and controls.MethodsThirty-seven women with chronic pelvic pain who underwent diagnostic laparoscopy on the suspicion of endometriosis participated along with 55 healthy and pain-free controls. All underwent quantitative sensory testing on six locations on the body to determine heat (HPT), cold (CPT) and pressure (PPT) pain thresholds. The PCS, the Pain Sensitivity Questionnaire (PSQ), the Hospital Anxiety Depression Scale, (HADS) demographics and clinical data were collected prospectively. Principal component analysis and orthogonal partial least square regressions were used to assess the associations between PCS scores and pain thresholds.ResultsThe women with CPP scored significantly higher on PCS than the healthy controls. PCS-helplessness, PCS-rumination and HADS-depression were significantly associated with pain thresholds for the whole group. In the CPP group, PCS-rumination, body mass index and PSQ were significant regressors for HPT and CPT. The PCS and the HADS subscales were strongly intercorrelated in women with CPP and were stronger regressors of group membership than the three pain thresholds. In the group of healthy control women, no relationships were found to be significant. The psychological variables were somewhat stronger significant regressors than pain thresholds (also significant) for group membership.ConclusionsWomen with CPP have significantly higher pain catastrophizing scores than women without CPP. The pain catastrophizing rumination factor is significantly associated with pain thresholds of heat and cold in CPP women. PCS and HADS are strongly intercorrelated and PSQ correlates positively with these variables. It seems that the psychological variables are important for group differentiation.ImplicationsThe results clearly indicate the need for a multimodal assessment (bio-psycho-social) of CPP patients including psychological symptoms such as catastrophizing, anxiety and depression. The registration of semi-objective pain thresholds captures both specific pain sensitivity information (mechanical pressure, cold or heat) and the degree of wide spread pain hypersensitivity. There is a need for future larger studies investigating whether certain profiles in the clinical presentations (including pain thresholds and psychological variables) are associated with outcomes after different types of interventions.

Chronic pelvic pain – pain catastrophizing, pelvic pain and quality of life

2018 ◽  
Vol 18 (3) ◽  
pp. 441-448 ◽  
Author(s):  
Megan Sewell ◽  
Leonid Churilov ◽  
Samantha Mooney ◽  
Tony Ma ◽  
Peter Maher ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Pain Catastrophizing ◽  
World Health Organisation ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional ◽  
Coping Responses

Abstract Background and aims Chronic pelvic pain (CPP) impacts significantly on the lives of women. Negative coping responses such as pain catastrophizing are thought to be significant in predicting both pain severity and outcome. The combined effect of the individual’s response to pain and its severity on their quality of life (QoL) has not been well studied in women with CPP. Aims were to determine the prevalence of pain catastrophizing in women with CPP and to examine the associations between pain catastrophizing and levels of dysmenorrhea, non-cyclical pelvic pain, dyspareunia, dysuria, dyschezia and QoL. Methods A cross-sectional study including women aged 18–50 years, referred to a tertiary gynecology outpatients department at an Australian women’s hospital in 2015. Participants completed questionnaires including: pain catastrophizing scale (PCS); pelvic pain levels in the prior 3 months; and the World Health Organisation Quality of life – Bref Questionnaire (WHOQoL-Bref). Statistical analysis was performed using STATA (StataCorp, USA Version13). Results Participants (n = 115) had a median age of 29.0 [interquartile range (IQR): 23.0–38.0] years. The Pain catastrophizing score revealed that 60/113 [95% confidence interval (CI): 48.6, 71.2] of participants had a clinically relevant total score ≥30. There were statistically significant positive correlations between pain catastrophizing scores and pelvic pain levels in all five pain categories studied, dysmenorrhea (ρ = 0.37, p = 0.0001), non-cyclical pelvic pain (ρ = 0.46, p<0.0001), dyspareunia (ρ = 0.32, p = 0.0008), dysuria (ρ = 0.32, p = 0.0005) and dyschezia (ρ = 0.38, p = 0.0012). Participants who reported maximal pain levels (5/5) had significantly higher median pain catastrophizing scores when compared to those who reported no pain (0/5) in all categories. Overall QoL was considered as “good” in 71/113 (95% CI: 60.1, 81.0) participants and “poor” in 42/113 (95% CI: 32.0, 53.0) participants. Comparison to Australian female norms revealed significantly lower QoL scores in the physical domain, across all ages, and in psychological domain for those aged <30 and 30–40 years. There was a significant association between increased catastrophizing scores and reduced odds of good QoL. An increase in PCS by one point is associated with a 6.3% decrease in the odds of good QoL [odds ratio (OR) per one-point increase: 0.94 (95% CI: 0.89, 0.98), p = 0.008]. Conclusions Pain catastrophizing is prevalent at clinically relevant levels in women with CPP across all domains. It is associated with higher pain levels and decreased QoL. Implications There is potential for further studies to investigate the predictive nature of pain catastrophizing and management targeting catastrophizing to improve outcomes in women with CPP.

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