Mind-body therapy eases chronic pelvic pain

NEW YORK (Reuters Health) - A type of mind-body treatment popular in Europe known as Mensendieck somatocognitive therapy can help ease chronic pelvic pain in women, with effects lasting several months after treatment ends, Norwegian researchers report.

Women with chronic pain often experience "somatic dissociation," or a loss of awareness of their own bodies, Dr. Gro K. Haugstad of the University of Oslo and colleagues note, suggesting that therapies that help restore this awareness could be helpful.

With Mensendieck therapy, patients are instructed on understanding the causes of pain and gradually increasing body movement, "experiencing new body awareness and motor patterns," the researchers explain. The therapy emphasizes correcting posture, movement, and breathing patterns.

In a previous study, Haugstad and colleagues found that Mensendieck therapy improved symptoms of pain and restored normal movement in a group of women with chronic pelvic pain. In the December issue of the American Journal of Obstetrics and Gynecology, they report one-year follow-up of these patients.

In the study, 40 women with chronic pelvic pain with no apparent biologic cause were randomly assigned to standard care (emotional support and help with other gynecological problems) or standard care plus 10 weeks of Mensendieck therapy.

All of the women in the Mensendieck therapy group saw significant improvements in posture, gait, movement, sitting posture, and respiration, while women in the control group stayed about the same.

And at one year after the beginning of the study, the women given the therapy showed additional improvement. Their pain scores had improved by 64 percent, while the pain scores were almost the same before and after a year of treatment for the control group.

Women in the movement therapy group also showed significant improvements in several measures of psychological distress.

Chronic pelvic pain may be a kind of "vicious circle," in which the patient adopts certain habits to protect the pelvic area that impair normal movement, Haugstad and her colleagues say. "It is important to break this chain of events, and move the focus from pain experience to coping with pain and coping with the fear of movement," they write.

The additional improvements seen among patients treated with Mensendieck therapy, the researchers add, suggests that these women "have learned to move in a more natural and relaxed manner."

It is estimated that 2 to 3 percent of the general female population complain of chronic pelvic pain, while as many as 40 percent of women visiting their gynecologist may be suffering chronic pelvic pain.

SOURCE: American Journal of Obstetrics & Gynecology, December 2009.