Chronic pelvic pain (CPP) and chronic pelvic pain syndrome (CPPS) are among the most challenging conditions to diagnose and treat. Despite the fact it is estimated that an average 26% of women are affected worldwide, a paucity of empirical work has been conducted to develop comprehensive evidence-based assessments and interventions that effectively address all aspects of the conditions (Brookes et.al., 2020). Despite such high prevalence rates, individuals suffering from these conditions often remain invisible and untreated, receive ineffective treatments, or endure interventions that are not trauma-informed. Regrettably, this is unsurprising when a significant gap exists in medical and clinical curriculums to effectively address pain syndromes overall (Bradshaw et al., 2017; Kress et al., 2015) often leading to frustration, increased mental distress, and inadvertent retraumatization of the patient. While the Institute of Medicine and the National Pain Strategy have both highlighted and acknowledged the educational gaps in pain management, and emphasized the crucial role clinicians plays in this field (Prasad et al., 2019), there is still much work to do.
This symposium aims to provide a comprehensive introduction to the complexities involved in understanding and treating these chronic conditions while emphasizing the often invisible and undetected trauma underlying these and other pain syndromes. The first of three presentations will explore the complex and multifaceted nature of CPP/CPPS, with an emphasis on the intersection of biological, psychological, and traumatic stress-related effects involving multiple organ systems and influenced by a range of factors, including neurological, musculoskeletal, inflammatory, and psychophysiological processes (Ahangari, 2014; Howard, 2003; Juganavar & Joshi, 2022; Varma & Gupta, 2005). A second presentation will highlight the results of a systematic review of the current CPP/CPPS literature examining specifically the role of sexual trauma, in the development and persistence of CPP/CPPS (Brooks et al., 2020; Fuentes & Christianson, 2018; Krantz et al., 2019; Moussaoui & Grover, 2022; Nelson et al., 2017; Panisch et al., 2022). This review will reveal and explore the evidence highlighting various studies reporting elevated prevalence rates of sexual abuse among women with chronic pelvic pain as well as outline the emerging evidence-based treatment guidelines (Vincent & Evans, 2021; Dun et al., 2015) and trauma-informed interventions (Lamvu et al., 2021; Ross et al., 2022). Finally, the third presentation will underscore the need for an integrative, multidisciplinary approach to assessment and treatment given the current limitations of the healthcare system. A preliminary model of patient care will be presented that comprehensively addresses both the physical and psychological aspects of CPP and CPPS. This discussion will emphasize the importance of a trauma-informed, interdisciplinary model to improve patient outcomes, as well as identify practical clinical strategies that can be implemented across a variety of settings. By understanding these interconnected components, researchers and clinicians will gain a comprehensive perspective on effective assessment and treatment strategies for working with patients suffering with these complex chronic pain conditions.
