Management of pelvic floor muscle pain with pelvic floor physiotherapy incorporating neuroscience-based pain education: A prospective case-series report

The aim was to present a prospective case series describing the management and outcomes of physiotherapy, incorporating neuroscience-based education for women with persistent pelvic pain and with diagnosed pelvic floor muscle pain. Participants were women who attended a multidisciplinary pelvic pain clinic and who were assessed, diagnosed and referred to physiotherapy by a gynaecologist with a special interest in pelvic pain. All participants received individualised physiotherapy treatment, underpinned by a biopsychosocial approach to assessment and management. The psychosocial component used was a psychologically informed treatment approach and neuroscience-based education. Of the 26 participants who completed a course of physiotherapy, 11 provided complete data at discharge from treatment. Following treatment: Numerical Rating Scores for pain decreased by a mean of >=2/10 points, in eight of 10 questions. Scores for the Pelvic Health Screening Questionnaire improved by a mean of 23% (p=0.01), indicating improved coping and reduced catastrophising. Scores for the Pelvic Floor Bother Questionnaire improved by 11% (p=0.01), indicating a significant reduction in co-existing pelvic floor symptoms. The Female Sexual Function Index did not change significantly following treatment (p=0.72). At follow-up, all participants reported some improvement on the Patient Global Impression of Improvement, with 8/11 reporting to be 'very much better' or 'much better'. The results suggest that a psychologically informed approach to the physiotherapy management of women with persistent pelvic pain, which has a pelvic floor muscle pain component, may be an effective management option, deserving further research.