APTA Header

Expanding the Clinician’s Toolbox: A Multisystems Approach to Interventions for Pelvic Pain and Gastrointestinal Dysfunction

Wednesday, February 24, 2021
4:00 PM – 5:30 PM

Evidence to support the benefits of medical, psychological, and physical therapy interventions in treating pelvic pain is well documented in the literature. Specifically, the aim of pelvic floor physical therapy, or PFPT, treatment is two-fold: to reduce sexual and genital pain and to restore or improve sexual function. Due to the complexity of persistent pelvic pain, treatment approaches in PFPT include the biopsychosocial model. Specifically, the application of a somatic based psychotherapeutic intervention can enhance functional outcomes. Many patients suffer from a combination of urogenital, gastrointestinal, and sexual dysfunction associated with pelvic pain and a multisystem approach is needed to treat functional impairments. Based on emerging pain science research, central sensitization of pain may play a role in the production of bothersome conditions such as urinary frequency, vulvar pain, and anal fissures. In addition, unintentional supragastric belching, defined as an episode when the diaphragm is repeatedly used to pull air into the esophagus, is a learned behavior further contributing to pelvic dysfunction. Using a multisystems approach for  patient education and behavioral modification is important to reduce unwanted behaviors.