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The Puzzle of Pelvic Pain: A Rehabilitation Framework for Balancing Tissue Dysfunction and Central Sensitization II: A Review of Treatment Considerations

Vandyken, Carolyn BHSc, PT; MDT, Cred CCMA(Acup); Hilton, Sandra MS, PT

Journal of Women's Health Physical Therapy:
doi: 10.1097/JWH.0b013e31824e0ab4
Clinical Commentary

Physical therapists have been instrumental in guiding the medical system away from “end-organ” focus in the assessment and treatment of persistent pelvic pain. However, for the most part physical therapists remain in a bio-medical model of treatment focusing on tissue dysfunction as a framework for the assessment and treatment of persistent pelvic pain. This article proposes a framework that integrates current understanding of local tissue dysfunction with the wider context of sensitized protective mechanisms within the spinal cord and brain. Current concepts in pain science, particularly as it relates to the Neuromatrix and central sensitization, lead away from bio-medicalism towards a bio-psycho-social model of evaluation and treatment of persistent pelvic pain.

Author Information

The authors declare no conflicts of interest.

Copyright © 2012 Section on Women's Health, American Physical Therapy Association

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