Physiotherapy as Empowerment - Treating Women with Chronic Pelvic Pain

Abstract

Chronic pelvic pain (CPP) is a frequent and challenging diagnosis within gynaecology. A new kind of psychosomatic physiotherapeutic treatment is delineated and tested with patients where persistent CPP has been the dominating symptom. The treatment modality is described as ?triangle treatment?, where the particular aim is an active participation of a responsible patient. The study describes physiotherapy within the framework of body awareness therapy with five women. During 20 sessions physiotherapy was conducted in close collaboration with a female gynaecologist. Both qualitative (participant observation, field notes, narratives) and quantitative (Body Awareness Scale and sick-leave data) research approaches were used. One purpose of the study was to focus on the working methods of the physiotherapist and throw light on management and interventions in short-term therapy. A focus group of experts was applied for analysing and interpreting the process and treatment outcome. The manner of working with the pain ?as an ally? is elucidated. The women improved with regard to psychomotoric function, pain and working capacity. The study points at the relationship between accomplished home exercises, patients' formulated ?desired goals? and outcome. The capability of constructing distinct ?desired goals? was closely related to improvement. A model on physiotherapy has been developed which stresses the polarities in the physiotherapist's work (demanding/accepting; distance/closeness; movements/talks) and the ?art of adjusting? as the overall method of working. The model also encompasses bodily reactions appearing in the therapy room as an aid to regulate the physiotherapy.