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urinary chronic pelvic pain
Impact of Resilience on Chronic Pelvic Pain | Image Courtesy of Anthony Tran via Unsplash

A recent pilot study looked at how resilience affects patients with urinary chronic pelvic pain (UCPP) conditions and chronic overlapping pain conditions (COPCs). Resilience can be defined as the “capacity to adapt successfully to disturbances that threaten a patient's viability, function or development.” (Southwick et al., 2014) Resilience is now an important aspect in the treatment of pain, as it can increase psychosocial well‐being and the quality of life in patients living with chronic pain. (Casale et al., 2019)

Resilience levels and urinary chronic pelvic pain conditions

Previous studies have measured resilience levels in other chronic pain conditions. This was the first study to look at this relationship with UCPP. In this study the participants were placed in two groups, pelvic pain only and widespread pain (WP). All the participants rated their pain as well as answered several questionnaires which included the Pain Catastrophizing Scale (PCS), 17 Depression Anxiety and Stress Scale (DASS ‐21) 18 and 14 item‐Resilience scale (RS‐14). 

Catastrophizing and Resilience

High levels of catastrophizing were found in both groups of patients (UCPP and WP), but those with widespread pain, and particularly females, demonstrated significantly higher levels of catastrophizing than patients with pelvic pain only. Consistent with other research they found  poor resilience in patients living alone and not engaged in work activity.  This observation demonstrates that emotional and social relationships improve resilience and well‐being. 

Further research needs to be done to determine if  catastrophizing is due to higher levels of pain and number of COPCs or vice‐versa. Other studies have observed that changes in catastrophizing are associated with improvement in pain intensity, depression levels, pain‐related anxiety and physical and psychosocial disabilities. (Giannantoni et al., 2021)  Cognitive behavioral therapy (CBT) has demonstrated improvement in patient disability, pain and catastrophizing (Tripp et al., 2011) This supports the need for urinary chronic pelvic pain patients to participate in a multimodal treatment style to address all domains of pain. 

At Femina Physical Therapy, we believe in an interdisciplinary approach to treating chronic pain. In most locations we offer physical therapy, massage therapy, somatic stress therapy and resilience building

Use this link if you are ready to make an appointment with one of our trained physical therapists.

References

Casale R, Sarzi‐Puttini P, Botto R, et al. Fibromyalgia and the concept of resilience. Clin Exp Rheumatol. 2019;37:S115‐S113.

Giannantoni, Antonella, et al. “Resilience in the Face of Pelvic Pain: A Pilot Study in Males and Females Affected by Urologic Chronic Pelvic Pain.” Wiley Online Library, John Wiley & Sons, Ltd, 25 Mar. 2021, onlinelibrary.wiley.com/doi/10.1002/nau.24659.

Southwick SM, Bonanno GA, Masten AS, Panter‐Brick C, Yehuda R. Resilience definitions, theory, and challenges: interdisciplinary perspectives. Eur J Psychotraumatol. 2014; 5(1):25338.

Tripp DA, Curtis Nickel J, Katz L. A feasibility trial of a cognitive‐behavioural symptom management program for chronic pelvic pain for men with refractory chronic prostatitis/chronic pelvic pain syndrome. Can Urol Assoc J. 2011; 5: 328‐ 332.

What Our Patients Have to Say

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Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

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Locations

Beverly Hills:

9012 Burton Way
Beverly Hills, CA 90211

Telephone: (310) 871-9554

The Beverly Hills office is convenient to Mid-Wilshire, West Hollywood, Hollywood, Beverlywood, Korea Town, Downtown LA, Culver City, Century City, Santa Monica and Malibu.

Hours:

Monday 12:00-5:00
Tuesday 7:00-6:00
Wednesday CALL
Thursday 2:00-6:00
Friday 7:00-6:00

Pasadena:

350 S. Lake Avenue #220
Pasadena, Ca 91101

Telephone: (818) 873-1403

Our Pasadena location is convenient to Glendale, Montrose, Burbank, Silver Lake, Los Feliz, Atwater Village, and Eagle Rock.

Hours:

Monday 7:00-6:00
Tuesday 7:00-4:00
Wednesday CALL
Thursday 7:00-4:00
Friday CALL

Sherman Oaks:

13425 Ventura Blvd. Suite 200
Sherman Oaks, California 91423

Telephone: (818) 877-6910

The Sherman Oaks office is adjacent to Studio City and serves the Bel Air, Brentwood, West LA, Mulholland, Beverly Hills, Encino, Calabasas and San Fernando Valley area.

Hours:

Monday 7:30-6:00
Tuesday 7:00-6:00
Wednesday 7:00-6:00
Thursday 8:00-6:00
Friday 7:00-6:00