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Team approach delivers better outcomes for pelvic pain sufferers, study says

Research 16 Oct 2018
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Women suffering from chronic pelvic pain endure less pain and enjoy a better quality of life when treated by a team of specialists, a new study has revealed.

Fewer visits to the doctor or emergency department was another key finding of the study, which was undertaken by researchers at the University of British Columbia, Canada.

Chronic pelvic pain is a common condition that affects around 15% of women worldwide. It occurs in the area below the belly button and above the legs, and is defined as pain that is present on most days for six months or more. As the pelvic region is home to the bowel, bladder and reproductive organs, the symptoms of chronic pelvic pain are varied, and the condition is complex.

Chronic pelvic pain has often been treated using an acute pain model (eg, using strong painkillers) or single therapy model (eg, one specialist involved). However, due to the multifaceted nature of the condition, there has been a shift toward an integrated model, in which a team of specialists work together to help improve a patient's quality of life.

Published in the American Journal of Obstetrics and Gynaecology, the study followed 296 women over a one-year period who had been diagnosed with chronic pelvic pain. The women received care from a team of specialists at an integrated medical centre, with their care including physiotherapy, psychological therapies, pain education and gynaecological management.

This care model, known as an interdisciplinary approach, involves multiple specialists working together to achieve a common goal for a patient.

Jean Hailes gynaecologist Dr Janine Manwaring says that this study and others demonstrate the effectiveness of an interdisciplinary team approach in managing chronic pelvic pain.

"Chronic pain is not just about the immediate pain. It also involves and affects multiple areas of health and life, so treating the whole person is crucial," says Dr Manwaring.

The interdisciplinary care approach was found to benefit women in the study, with reductions in pain severity, improvements in quality of life, and fewer visits to the doctor or the emergency department observed during the one-year study.

Dr Manwaring agrees with the shift away from an acute pain model. She says that an interdisciplinary approach helps to manage the plethora of bodily systems affected by the condition.

"Depending on where the pain is experienced, there may be specific treatment directed to that area, such as physiotherapy, acupuncture, or surgery, for example. Improving overall physical health is essential, and can involve nutrition, improving immune and endocrine function, and exercise," she said.

Dr Manwaring says that psychological health is sometimes overlooked or downplayed. However, she believes it is a key component of pelvic pain management.

"In addition to treating any underlying mood issues, educating about the pain science, triggers, and management techniques, as well as teaching mindfulness can help to make significant improvements to the woman's quality of life," she says.

"We want women suffering from chronic pelvic pain to know that through a dedicated interdisciplinary team approach, that they will be able to live with the condition in a manageable way, without negatively impacting their daily function."