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Catastrophizing, Depression, and Pain in Male Chronic Pelvic Pain

A recent article titled "Pain, Catastrophizing, and Depression in Chronic Prostatitis/Chronic Pelvic Pain Syndrome" describes the variations in patient symptom report and perception of the condition. The article describes the evidence-based links between chronic pelvic pain and anxiety, depression, and stress, and highlights the important role that coping mechanisms have in reported pain and quality of life levels. One of the ways in which a provider can assist in patient perception of health or lack thereof is to provide current information about the condition, instruct the patient in pathways for healing, and provide specific care that aims to alleviate concurrent neuromusculoskeletal dysfunction.

Most pelvic rehabilitation providers will have graduated from training without being informed about chronic pelvic pain syndromes. And as most pelvic rehabilitation providers receive their pelvic health knowledge from continuing education courses, unless a therapist has attended coursework specifically about male patients, the awareness of male pelvic dysfunctions remains low. If you are interested in learning about male pelvic health issues, the Institute introduces participants to male pelvic health in the Level 2A series course. The practitioner who would like more information about male patients can attend the Male Pelvic Floor Function, Dysfunction, and Treatment course that is offered in Torrance, CA at the end of this month.

The authors in this study point out that chronic pelvic pain is not a disease, but rather is a symptom complex. Despite the persistent attempts to identify a specific pathogen as the cause of prostatitis-like pain, this article states that "…no postulated molecular mechanism explains the symptoms…" As with any other chronic pain condition, research in pain sciences tells us that behavioral tendencies such as catastrophizing is not associated with improved health. The authors utilized a psychotherapy model in developing a cognitive-behavioral symptom management approach and found significant reductions in CPP symptoms. The relevance of this information for our patient population includes having the ability to screen our patients for depression, to recognize tendencies to catastrophize, and to implement useful strategies for our patient.

What does your facility currently use as a depression screening tool? Having this information at hand when communicating with a referring provider is very helpful. Explaining the biology of the vicious cycle of emotional stress and pain responses can help a patient understand why following up on a referral to a psychologist or counselor may be helpful towards his health. Identifying catastrophizing as the patient who is hypervigilent about symptoms, ruminates about his condition, expresses an attitude of helplessness, or magnifies the threat of the perceived pain can aid in identification of the patient who needs more than a few stretches, a TENS unit, or manual therapy.

A new course offered this year by the Institute will provide excellent foundational background information as well as practical patient care techniques about emotional and psychological principles that influence chronic pain. This course, Integrating Meditation and Neuropsych Principles to Maximize Physical Therapy Interventions, is instructed by Nari Clemons, a physical therapist who excels in pelvic rehabilitation, and Shawn Sidhu, a psychiatrist with a special interest in mind body medicine. The course is offered only one time this year, in September in Illinois, so sign up early!

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Upcoming Continuing Education Courses

Boundaries, Self-Care, and Meditation - Remote Course

Sep 12, 2020 - Oct 11, 2020
Location: Replacement Remote Course

Mobilization of Visceral Fascia: The Urinary System - Phoenix, AZ (Postponed)

Oct 2, 2020 - Oct 4, 2020
Location: Banner Physical Therapy and Rehabilitation

Mobilization of Visceral Fascia: The Urinary System - Medford, OR Satellite Location

Oct 2, 2020 - Oct 4, 2020
Location: Asante Rogue Valley Medical Center

Mobilization of Visceral Fascia: The Urinary System - Self-Hosted

Oct 2, 2020 - Oct 4, 2020
Location: Self-Hosted Course

Mobilization of Visceral Fascia: The Urinary System - San Diego, CA Satellite Location

Oct 2, 2020 - Oct 4, 2020
Location: FunctionSmart Physical Therapy

Mobilization of Visceral Fascia: The Urinary System - Colorado Springs, CO Satellite Location

Oct 2, 2020 - Oct 4, 2020
Location: Manual Edge Physiotherapy

Mobilization of Visceral Fascia: The Urinary System - Fairlawn, NJ Satellite Location

Oct 2, 2020 - Oct 4, 2020
Location: Bella Physical Therapy

Low Pressure Fitness for Pelvic Floor Care - Trenton, NJ (Postponed)

Oct 2, 2020 - Oct 4, 2020
Location: Robert Wood Johnson Medical Associates

Pelvic Floor Level 1 - Grandville, MI Satellite Location

Oct 3, 2020 - Oct 4, 2020
Location: Apogee Therapy Center

Pelvic Floor Level 1 - Ann Arbor, MI Satellite Location

Oct 3, 2020 - Oct 4, 2020
Location: Probility Physical Therapy

Pelvic Floor Level 1 - Lansing, MI (Postponed)

Oct 3, 2020 - Oct 4, 2020
Location: Physical Therapy Services of Lansing

Pelvic Floor Level 1- Canton, OH (POSTPONED)

Oct 3, 2020 - Oct 4, 2020
Location: Aultman Hospital

Pudendal Neuralgia and Nerve Entrapment - Minneapolis, MN (Postponed)

Oct 3, 2020 - Oct 4, 2020
Location: Viverant

Yoga for Pelvic Pain - Remote Course

Oct 3, 2020 - Oct 4, 2020
Location: Replacement Remote Course

Male Pelvic Floor - Colorado Springs, CO

Oct 3, 2020 - Oct 4, 2020
Location: St. Francis Medical Center

Oncology of the Pelvic Floor Level 2A - Chicago, IL (Postponed)

Oct 3, 2020 - Oct 4, 2020
Location: Advocate Illinois Masonic Medical Center

Yoga for Pelvic Pain - Albany, NY (Postponed)

Oct 3, 2020 - Oct 4, 2020
Location: The Sage Colleges

Pelvic Floor Level 1 - Satellite Lab Course

Oct 3, 2020 - Oct 4, 2020
Location: Replacement Remote Course

Pelvic Floor Level 1 - Self-Hosted

Oct 3, 2020 - Oct 4, 2020
Location: Self-Hosted Course

Pelvic Floor Level 1 - Canton, OH Satellite Location (SOLD OUT)

Oct 3, 2020 - Oct 4, 2020
Location: Aultman Hospital

Boundaries, Self-Care, and Meditation - Princeton, NJ

Oct 9, 2020 - Oct 11, 2020
Location: Princeton Healthcare System

Pelvic Floor Level 2A - Self-Hosted

Oct 10, 2020 - Oct 11, 2020
Location: Self-Hosted Course

Pelvic Floor Level 1 - Boston, MA (Postponed)

Oct 10, 2020 - Oct 11, 2020
Location: Northeastern University

Pelvic Floor Level 1 - San Diego, CA Satellite Location

Oct 10, 2020 - Oct 11, 2020
Location: Water and Sports Physical Therapy Clinics

Pelvic Floor Level 2A - Kansas City, MO (Postponed)

Oct 10, 2020 - Oct 11, 2020
Location: Centerpoint Medical Center

Pelvic Floor Level 1 - Appleton, WI Satellite Location

Oct 10, 2020 - Oct 11, 2020
Location: Orthopedic & Spine Therapy

Pelvic Floor Level 1 - San Diego, CA (Postponed)

Oct 10, 2020 - Oct 11, 2020
Location: Water and Sports Physical Therapy Clinics

Osteoporosis Management - Remote Course (Rescheduled)

Oct 10, 2020 - Oct 11, 2020
Location: Replacement Remote Course

Pregnancy Rehabilitation - Remote Course

Oct 10, 2020 - Oct 11, 2020
Location: Replacement Remote Course