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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Werner, Mads


CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

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1877-8879
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Volume 19, Issue 2

Issues

Characteristics of women with chronic pelvic pain referred to physiotherapy treatment after multidisciplinary assessment: a cross-sectional study

Ane Sigrid Nygaard
  • Corresponding author
  • Norwegian National Advisory Unit on Incontinence and Pelvic Floor Health, University Hospital of North Norway, Pb. 96, 9038 Tromsø, Norway
  • Women’s Health and Perinatology Research Group, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway, Phone: 0047 – 92258582
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Mona Stedenfeldt
  • Norwegian National Advisory Unit on Incontinence and Pelvic Floor Health, University Hospital of North Norway, Tromsø, Norway
  • Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
  • Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Pål Øian
  • Women’s Health and Perinatology Research Group, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway
  • Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Gro Killi Haugstad
Published Online: 2019-01-31 | DOI: https://doi.org/10.1515/sjpain-2018-0308

Abstract

Background and aims

Chronic pelvic pain (CPP) in women is a complex condition that can seriously impact health and quality of life. Clinical guidelines for CPP place great demands on healthcare professionals, as they require both specialized knowledge about the pelvic area and knowledge of the mechanisms of chronic pain. To ensure best possible assessment and treatment of these women it is important to bring about more knowledge of the special CPP features. The purpose of this paper is to describe the characteristics of women with CPP evaluated at the University Hospital of North Norway, and further referred to physiotherapy. The frequency of having a history of abuse or previous pelvic surgery will also be reported, and analyses performed to investigate if subjective health status differs between women with and without these experiences.

Methods

We collected cross-sectional data from 62 women with CPP aged 20–65 (mean age 38.0), referred to physiotherapy after assessment by medical specialists. Data were collected by semi-structured interviews for demographic variables and medical history, and self-administered questionnaires on pain intensity, sexual function, urinary incontinence (UI), anal incontinence (AI), obstructed defecation syndrome (ODS), subjective health complaints (SHC) and symptoms of anxiety and depression.

Results

Pain duration of more than 10 years was reported by 42%, mean pain score was 4.7/10, and analgesics were used weekly by 48%. Previous pelvic or abdominal surgery was reported by 71%, and sick leave >12 weeks the last year by 34%. Reduced sexual desire was reported by 78%, dyspareunia by 73%, UI by 54%, AI by 23%, and obstructed defecation syndrome (ODS) by 34%. More than 90% reported musculoskeletal or pseudoneurologic complaints. Anxiety and depression scores defined as requiring treatment were reported by 40%. Abuse was reported by 50%, and associated with significantly more reports of ODS (p=0.02), more SHC (p=0.02) and higher anxiety scores (p=0.009). Analgesic use and sick leave were significantly higher both among women with a history of abuse (p=0.04 and p=0.005) and among those with previous surgery (p=0.04 and p=0.02). Women with previous surgery reported significantly lower pain intensity during intercourse than those without previous surgery (p=0.008).

Conclusions

Women with CPP have complex symptoms and high scores for both physical and psychological complaints. Women exposed to abuse have especially high scores related to analgesic use, sick leave, ODS, anxiety and SHC. Women with previous surgery report more analgesic use and sick leave, and lower pain intensity during intercourse, than those without previous surgery.

Implications

This study illustrates the complexity of CPP and highlights the need for health professionals to have specialized knowledge of the possible features of the condition. Previous abuse seems to be more associated with poor scores on several health outcomes than surgery, but this needs to be investigated further.

Keywords: pelvic pain; chronic pain; women’s health; subjective health outcomes

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About the article

Received: 2018-09-12

Revised: 2018-12-06

Accepted: 2018-12-18

Published Online: 2019-01-31

Published in Print: 2019-04-24


Authors’ statements

Research funding: This study was funded by The Norwegian Fund for Post-Graduate Training in Physiotherapy and by Northern Norway Regional Health Authority.

Conflict of interest: Authors state no conflict of interest.

Informed consent: Informed consent was obtained from all individuals included in this study.

Ethical approval: The research related to human use complies with all the relevant national regulations, institutional policies and was performed in accordance with the tenets of the Helsinki Declaration. The Regional Committee for Medical and Health Research Ethics North approved the study (18.09.2014 2014/1398).


Citation Information: Scandinavian Journal of Pain, Volume 19, Issue 2, Pages 355–364, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1515/sjpain-2018-0308.

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©2019 Scandinavian Association for the Study of Pain. Published by Walter de Gruyter GmbH, Berlin/Boston. All rights reserved..Get Permission

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