This multi factorial condition affects every individual in a unique manner. The Pelvic Pain Clinic places great emphasis on understanding the multiple factors affecting a client suffering with CPPS and Prostatitis including Biological, Psychological and Sociological factors. With this in mind Karl uses a BioPsychoSocial approach in the treatment of all his patients
What is a BioPsychoSocial approach?
The use of a BioPsychoSocial approach was proposed by George Engel in the 70’s. It takes into account the multiple aspects of a patients life that can contribute to their pain state. It looks beyond a single causative factor and weighs up the individual, addressing not only their biological factors (muscle tightness, increased sensitivity to the nervous system, immune response factors contributing to increased sensitivity, fight and flight or stress response, changes to breathing patterns etc.), but also psychological factors (catastrophisation, fear avoidance, hyper-vigilance, anxiety, worry, procrastination, depression) and social factors (what it means to have pelvic pain in the work environment, how it changes relationships with friends and family, what happens when the individual starts to socialise less, excluding themselves from those activities that provide them with a sense of community, self and a social life. Plus it address the awkwardness of the condition, its physical location and the distress of not being able to talk openly about it, unlike neck or back pain for example).
Up until now a traditional model of healthcare has been described as a biomedical approach, only considering single factors (the prostate, an infection, anterior hip tilt etc.). The approach has been to only focus on primary factors and to treat them with traditional medical interventions (antibiotics, non-steroidal anti-inflammatory drugs (NSAID’s), antidepressants etc. or through postural correction techniques like chiropractics). To date this has not been a proven, nor successful model in the treatment of male pelvic pain.
In adopting a BioPsychoSocial model the Pelvic Pain Clinic looks to treat the whole patient, not just single causative factors that may or may not contribute to the patients condition
Before treatment can begin
Before the treatment can begin an extensive client consultation and assessment is necessary to understand the genesis of the condition and how best to treat the individual. Prior to the initial session we will email you the ‘Client Intake Forms.’ These need to be filled in beforehand and emailed back prior to the initial Skype/telephone consultation. To build up a clear picture Karl uses a number of intake forms covering a range of Bio, Psyhco and Social factors including the GAD7 form (generalised anxiety disorder), PCS-EN (patient catastrophisation scale) NIH-CPSI (National Institute of Health Chronic Prostatitis Score Index), PSEQ (pain self efficacy questionnaire) an his own intake forms, including the IPQ-R-PP which is an illness perception questionnaire revised for pelvic pain. The subsequent treatment will be engineered on the information provided in the intake forms and discussions taking place during the initial telephone/Skype consultation.
Initial Skype/telephone consultation
Once the completed forms have been emailed or posted back then we will arrange an initial Skype/telephone consultation. This typically lasts about 30 minutes and provides Karl with a chance to chat with the patient about their case. The session is used to bring colour to the intake forms, filling in blanks and creating a good picture of the presenting case. It allows the patient a chance to freely discuss their case (quite often the first time a patient is given this opportunity). Karl will provide feedback and advice in this initial session. In some cases he will suggest a referral to another specialist at this junction. He may not feel that a face to face session is needed and will advise accordingly offering practical solutions and recommendations. Or, he will suggest that the best plan of action is to come for face to face sessions. Whatever the outcome Karl will always have the patients best interests at heart. He is open, frank, realistic and honest with all of his patients.
The face to face session
Each face to face session lasts approximately 100 minutes. The emphasis of the face to face session is to fully assess the patient and provide a tailored self care programme. Each session is bespoke and individual to the patient. As each patients presenting case is unique Karl does not use an off the shelf approach. Instead he combines the multiple factors of the BioPsychoSocial model to find the right keys to unlock each individual case. The face to face session may include some or all of the below methods and approaches
- Pain management and education
- Therapeutic movement analysis and re-education
- Relaxation techniques
- Lifestyle adaptations
- Internal assessment of the pelvic floor
- Manual massage therapy
- Trigger point therapy
After each session you will receive a unique report covering much of what was discussed in the session. It will outline key concepts covered and relevant information to assist you in your recovery. It will also include your own personalised self care programme for you implement on a daily basis to manage and reduce your symptoms, improve your quality of life and return you to meaningful activity.
Self care programme
Because self-care is central to a patient’s full recovery, you will be provided with a bespoke home self care programme. Karl places great emphasis on the patient being the driver in their recovery, not just a passenger. This allows you to take control of your symptoms from the comfort of your own home. This may include combinations of mindfulness, meditation, meaningful movement, meaningful activity, stretching, yoga, social activities, self massage, supplementation, lifestyle and dietary changes to name a few. The self care programme is developed in conjunction with your input. Karl will always balance good practice and sensible, realistic and achievable programmes with the individuals guidance. This creates greater opportunity for healthy habits to be formed, unhealthy ones to be broken and a greater chance of recovery
Follow up sessions
All follow up sessions will last approximately 70 minutes. Karl will provides each patient with a bespoke self care programme allowing you to focus on your own recovery each and every day. Karl encourages independence and guides self confidence. With this in mind he typically sees patients every 4 weeks for follow up sessions. During this session your self care programme will be reviewed, adapted and modified where necessary. Each follow up session builds on the previous one, creating a naturally flowing and progressive recovery. In between sessions Karl provides full email support to all of his patients. Often in between sessions the patient may find he has questions or concerns around his condition, or programme and these are easily addressed through this ongoing support
If you have any questions regarding the treatment or Karl’s approach please contact the clinic here