Effect of physiotherapy-led group therapy on pain reporting and quality of life in women with chronic pelvic pain

Female persistent pelvic pain (PPP) is a complex and often debilitating condition requiring multi-disciplinary input for effective management. Increasing recognition of the important role of Physiotherapy in treating this patient cohort led to referral numbers to Women’s Physiotherapy at the Women’s and Children’s Hospital (WCH) increasing in an unsustainable way for the individualised care approach in place. A more efficient and coordinated approach was required to ensure women with PPP were able to access the care they needed in a timely manner, while maintaining the positive clinical outcomes achieved through a traditional care pathway. This project tested the impact of implementing best practice chronic pain management strategies, proven effective with other patient groups such as chronic back pain sufferers, on clinical outcomes and consumer satisfaction for women referred with PPP, when compared to the usual model of care. Eligible women were recruited into one of three treatment arms; 1) individual consultations (usual care), 2) an introductory group pain science education session followed by individual care and 3) an introductory group pain science education session followed by weekly group therapy sessions and individual care. The study demonstrated the benefit of Physiotherapy in the management of PPP, with statistically significant improvements in all clinical outcome measures and highly positive consumer feedback observed across all treatment arms. It demonstrated that the addition of a group pain science education session as a precursor to individual consultation and care (treatment arm 2) results in improved clinical outcomes (with respect to self-reported impact of pelvic pain on function and participation), when compared to those receiving individual consultation alone (treatment arm 1). While the addition of an 8-week group exercise program (treatment arm 3) demonstrated statistically significant improvements for those in the group, there was no significant added benefit when compared women assigned to treatment arm 2.