Systematic review reports the best web sites for Bladder Pain Syndrome

A good resource for patient

Tirlapur SA, Leiu C, Khan KS.  Int Urogynecol 2013;24:1257-1262.

 

www.ic-network.com

www.ichelp.org

www.painful-bladder.org

www.niddk.nih.gov

Recognition of central sensitization in patients with musculoskeletal pain: application of pain neurophysiology in manual therapy practice.

Nijs J, Van Houdenhove B, Oostendrop RAB. Manual Therapy 2010 15:135-141.

Pelvic PT distance journal club 3/5/14

Beth Shelly PT, DPT, WCS, BCB PMD

Mechanism based clinical guidelines using medical diagnosis and history, clinical examination

·         Primary hyperalgesia - acute pain - several days - sensitization of the nociceptors to protect from further damage - local phenomenon

·         Secondary hyperalgesia - chronic pain -  increased responsiveness of dorsal horn neurons in the spinal segments of the primary nociceptors - central sensitization

Central sensitization (CS) - defined by Meyer 1995 - "an augmentation of responsiveness of central neurons to input from unimodal and polymodal receptors."

·         Altered sensory processing in the brain

·         Impaired descending inhibition of pain

·         Overactive ascending pain facilitatory pathways

·         Temporal summation of secondary pain = wind up

·         Long term enhancement of synapses in some areas of the brain

·         Net result

o   Augmented nociceptive signal

o   Increase responsiveness to a variety of peripheral stimuli

o   Decrease tolerance of senses

"How to explain central sensitization to patients with 'unexplained' chronic musculoskeletal pain: Practice guidelines."

Nijs J, et al. (2011)  Manual Therapy  16(5):413-418.

Pelvic PT Distance Journal Club 3/5/14

Beth Shelly PT, DPT, WCS, BCB PMD

Prior to starting rehab

·         Correct maladaptive pain beliefs

·         Reconceptualize pain

·         Affect deep learning

·         Resulting in the perception that pain is less dangerous

RCT - short term pain education alone is more effective for pain relief and improving pain self-efficacy than pain education and group exercise for patients with chronic LBP (Ryan 2010)

Just handing the patient a booklet is not effective in changing beliefs, need to have individually tailored sessions, one on one in person or phone in patients with fibromyalgia. (Van Oosterwijck 2013)

3/5/2014 Pelvic Physiotherapy Distance Journal Club

Time - 8:30 PM EST for one hour

FreeConfrenceCall.com

• 209-647-1000 access code 436790#
• Email Beth if you are having trouble accessing the call - beth@bethshelly.com
• Please keep background noise to a minimum (see below for more details)

This month’s discussion

Recognition of central sensitization in patients with musculoskeletal pain: application of pain neurophysiology in manual therapy practice. Nijs J, Van Houdenhove B, Oostendrop RAB. Manual Therapy 2010 15:135-141

How to explain central sensitization to patients with 'unexplained' chronic musculoskeletal pain: practice guidelines. Nijs J, et al. Manual Therapy 2011;16(5):413-418.

Sadowy AM, Brouwer HL, Finseth DL, Hagener KM, Lawrence AE, Hollman JH. Development of a Pelvic Floor Muscle Coordination Scale. Journal of Women’s Health Physical Therapy. 2010 September/December; 34 (3): 81-88.

Women’s Health Distance Journal Club 2/12/2014

Pamela Downey, PT, DPT, WCS, BCB-PMD

Esther Levy, SPT

Purpose: Examine the inter-rater reliability and criterion-related validity of a scale developed to quantify pelvic floor muscle (PFM) coordination through observational assessment.

Study Design: Descriptive study.

Participants: 20 women between 23-56 years of age (mean age 40 years) voluntarily responded to advertisements at the Mayo Clinic in Rochester, Minnesota to participate in the study. Both women without and with potential pelvic floor disorders served as subjects. Mean BMI was 27.2, and median parity was 1.5 (range 0-5), with median values of .5 vaginal deliveries (range 0-4) and median value of 0 Cesarean deliveries (range 0-3).