Conservative Care for Pelvic Pain

Not yet recruiting at 1 trial location
SK
LP
Overseen ByLaurel Proulx, PhD
Age: 18 - 65
Sex: Female
Trial Phase: Academic
Sponsor: Baylor University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores new ways to treat chronic pelvic pain (CPP) without specialized internal procedures. Researchers will compare three treatment methods: usual care with medication and exercise, innovative non-vaginal treatments like manual therapy and dry needling, and specialized internal therapy by a pelvic health expert. The goal is to determine which approach works best for women with persistent pelvic pain. Women who have experienced pelvic pain for at least three months, affecting their daily life, might be suitable for this trial. Participants will also assist in developing tools to predict who will benefit most from these treatments. As an unphased trial, this study offers a unique opportunity for participants to contribute to pioneering research that could improve treatment options for chronic pelvic pain.

Will I have to stop taking my current medications?

The trial does not specify whether you need to stop taking your current medications. However, since one group will receive usual care, which includes medications, it seems likely that you can continue your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that the treatments tested in this trial for chronic pelvic pain (CPP) are generally safe based on previous studies.

For Pain Neuroscience Education, research indicates it effectively reduces pain and enhances understanding of pain without causing significant side effects. It is usually well-tolerated and can help lessen disability and emotional issues.

Deep Paced Diaphragmatic Breathing Training has been studied for its impact on pain and quality of life. Results suggest it is safe and can improve symptoms related to pelvic pain and other conditions, with no major negative effects reported.

Extrapelvic Dry Needling targets muscles outside the pelvis to relieve pain. Studies have shown it reduces pain in women with CPP, with no serious side effects noted.

Manual Therapy involves physical manipulation of muscles. Evidence suggests it reduces pain and improves physical function. It is generally safe and well-tolerated in patients with CPP.

Lumbopelvic and Hip Therapeutic Exercise focuses on exercises for the lower back and hips. Research has shown these exercises reduce pain and improve quality of life in women with similar conditions, with a good safety record.

These treatments have been studied separately and are generally safe to use. However, individual experiences can vary, so discussing options with a healthcare provider is recommended.12345

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative, non-invasive techniques for managing chronic pelvic pain. Unlike standard treatments that often focus on direct interventions like medication or surgery, this trial investigates methods such as deep paced diaphragmatic breathing and extrapelvic manual therapy, aiming to address the sensory and motor dysfunctions that contribute to pain. By combining these approaches with pain neuroscience education, the trial seeks to provide a holistic alternative that could enhance the quality of life for those suffering from pelvic pain. This method emphasizes a more comprehensive understanding of pain management, potentially offering a new avenue for relief without the side effects associated with conventional treatments.

What evidence suggests that this trial's treatments could be effective for chronic pelvic pain?

Research has shown that understanding how pain works can reduce pain and disability in conditions like fibromyalgia and chronic low back pain. This finding suggests it might also help with chronic pelvic pain (CPP). In this trial, participants in the Emerging Field-expedient Care arm will receive a combination of non-vaginal interventions, including pain neuroscience education, deep paced diaphragmatic breathing training, and extrapelvic manual therapy and dry needling. Training in deep, slow breathing has been found to raise pain tolerance and improve mood, potentially benefiting those with CPP. Dry needling outside the pelvic area can reduce pain in women with CPP by addressing muscle and nerve issues. Manual therapy has also effectively reduced pain for women with CPP. Together, these new non-vaginal treatments show promise in managing CPP by improving pain, muscle function, and overall well-being.26789

Are You a Good Fit for This Trial?

This trial is for women service members with chronic pelvic pain lasting at least 3 months, not caused by recent surgery, infection, cancer or radiation. They shouldn't have other serious medical conditions or be pregnant/recently pregnant. A BMI over 33 (for Waco participants) and prior treatments like dry needling in the past 6 months are also exclusions.

Inclusion Criteria

I have had pain in my lower abdomen and pelvic area for at least 3 months.

Exclusion Criteria

Inability to read English at an 8th grade reading level (any participant unable to read the informed consent form, which will be written at an 8th grade level)
I have had treatments like dry needling or injections for back pain in the last 6 months.
Currently pregnant or pregnancy in the last 6 months
See 5 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive one of three treatment regimens: Usual Care, Emerging Field-expedient Care, or Gold-standard Intravaginal Specialist Care

12 months
Visits at 1 week, 1, 3, 6, and 12 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Chronic Pelvic Pain Education
  • Deep Paced Diaphragmatic Breathing Training
  • Extrapelvic Dry Needling
  • Extrapelvic Manual Therapy
  • Intravaginal and intrarectal pelvic floor physical therapy
  • Lumbopelvic and Hip Therapeutic Exercise
  • Pain Neuroscience Education
Trial Overview The study compares three approaches to treating chronic pelvic pain: usual care with medications and exercise; non-vaginal treatments like manual therapy, dry needling, and breathing training; and specialized intravaginal treatment. It aims to find effective non-vaginal treatments and develop tools to predict who will benefit from them.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Active Control
Group I: Emerging Field-expedient CareExperimental Treatment6 Interventions
Group II: Gold-standard Intravaginal Specialist CareActive Control5 Interventions
Group III: Usual CareActive Control2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Baylor University

Lead Sponsor

Trials
65
Recruited
67,600+

Congressionally Directed Medical Research Programs

Collaborator

Trials
59
Recruited
10,600+

Published Research Related to This Trial

Chronic pelvic pain treatment is complex and typically involves a combination of behavioral, medical, and procedural therapies, reflecting the multifaceted nature of the condition.
Recent advancements in understanding the neurobiology of chronic pelvic pain have led to the exploration of new treatment options, including neuromodulatory therapies and complementary medicine, alongside traditional focal therapies for specific pathologies.
New directions in the treatment of pelvic pain.Udoji, MA., Ness, TJ.[2021]
Chronic pelvic pain (CPP) significantly affects women's quality of life, and while physiotherapy is recommended as a treatment, the evidence supporting its effectiveness is limited and primarily derived from small, non-randomized studies.
Some evidence suggests that multidisciplinary interventions, including physiotherapy and Mensendieck somatocognitive therapy, may help manage CPP, but more high-quality randomized clinical trials are needed to establish definitive treatment guidelines.
Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review.Loving, S., Nordling, J., Jaszczak, P., et al.[2019]

Citations

Effect of Adding Diaphragmatic Breathing Exercises to ...The combination of DBE and CSE interventions compared to CSE alone showed improvement in the measured parameters for patients with CLBP.
The Effect of Breathing-based Pelvic Floor Muscle Training ...The aim of this study is to examine the effects of respiration-based physiotherapy approaches on menstrual symptoms, pain, and quality of life in women with PD.
Effect of a controlled diaphragmatic breathing session on ...It has been found that deep slow breathing training for 6 months increases pain thresholds and improves mood in healthy participants (Busch ...
Why Diaphragmatic Breathing is One of the Best Exercises ...Diaphragmatic breathing, also known as belly breathing, is an extremely effective and simple exercise with a multitude of benefits for your pelvic floor.
Can you breathe yourself to a better pelvic floor? A ...In general, the RCTs showed that training the PFM is significantly more effective to improve PFM variables and UI and POP than breathing ...
Diaphragmatic breathing exercises in recovery from fatigue ...This paper presents a study protocol that aims to investigate the acute effect of diaphragmatic breathing exercises on recovery of fatigue-induced changes in ...
The impact of core training combined with breathing ...This study demonstrated that both core training and combined training significantly improved outcomes in patients with CNLBP. Notably, the ...
Effects of manual diaphragm release on pain, disability and ...The current results provide preliminary evidence that the DMR might have positive effects in patients with CNP on reducing pain and increasing ...
Effect of motor control training and breathing exercises on ...This study aims to assess the effects of motor control training and breathing exercises on pain, disability and core muscle activity in women suffering from ...
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