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Podium
Introduction: Pain catastrophizing has been found to be correlated with worse outcomes following treatment for patients with CPP. Despite this association, there is scant evidence regarding catastrophication as a dynamic trait. We studied whether an improvement in pain catastrophizing during specialized pelvic floor physical therapy (PT) would portend better outcomes.
Methods: A retrospective chart review was performed among patients with CPP undergoing pelvic floor PT. Patients are given validated survey instruments three times over their treatment period, including the short-form Pain Catastrophizing Scale (PCS), Genitourinary Pain Index (GUPI), and Pelvic Floor Disability Index (PFDI-20). Patients were separated into catastrophication improvers (CI) and non-catastrophication improvers (NCI) based on their net change in PCS scores between weeks 0 and 6. Patients' changes on their GUPI and PFDI scores were compared utilizing unpaired two sample t-tests.
Results: CI patients (n=37, 74%) had a mean decrease in GUPI score of 5.16 compared to a mean decrease of only 0.46 points in the NCI group (n=13, 26%) after six weekly PT appointments (p=0.026). The CI group had improved scores for the urinary symptoms and quality of life subsections of the GUPI specifically (p < 0.05). There was a nonsignificant difference in the mean PFDI score change between the two groups of 28.29 (p=0.143) with CI patients improving their PFDI score by 17.35 whereas the NCI group had a mean increase in PFDI score by 10.94.
Conclusions: This is the first study to evaluate whether changes in pain catastrophication can affect outcomes in patients with CPP undergoing pelvic floor physical therapy. Preliminary data suggests patients who catastrophize less throughout treatment have improved pain symptoms, specifically in regard to urinary complaints and quality of life measures.
Source of Funding: None