Somatocognitive Therapy in Gynecological Pain: Chronic Pelvic Pain (CPP) and Provoked Vestibulodynia (PVD)

摘要

Background: Somatocognitive therapy (SCT) has been developed as a hybrid of physiotherapy and cognitive psychotherapy. In this short term body oriented therapy, the goal is to achieve new body awareness related to the activities of daily living and replace dysfunctional cognitive schemata related to somatosensory and emotional experiences. The working alliance between therapist and patient is important for therapy outcome. These studies investigated whether short term SCT improve pain level, motor patterns and psychological distress.Methods: Patients with gynecological pain were recruited to two studies, 40 patients with chronic pelvic pain (CPP) and 25 patients with provoked vestibulodynia (PVD). The CPP patients were randomized into an intervention study, whereas the PVD patients were included in a longitudinal study, both conducted on outpatient basis. Motor patterns were assessed with the Standardized Mensendieck Test (SMT, assessing posture, movement, gait, sitting posture and respiration). Pain level was assessed by means of a VAS score, and psychological distress evaluated by GHQ -30. Both groups were followed for a period after end of therapyResults: In both studies we demonstrated considerable reduction in pain scores and psychological distress, as well as improved motor patterns. Follow-up evaluations showed significant further improvement in all tests.Conclusions: Somatocognitive therapy is a new approach that appears to be very promising in the management of chronic gynecological pain. Short term outpatient treatment significantly reduces pain experience and psychological distress, and improves motor function.