Multidisciplinary Approaches to Assessment and Management of Chronic Pelvic Pain in Women: Nursing, Midwifery, Physiotherapists, and Allied Clinical Perspectives
Abstract
Background: Chronic pelvic pain (CPP) is a multifactorial condition affecting both women and men, characterized by persistent pain for at least three to six months. Its pathophysiology involves complex interactions between peripheral nociceptive input, central sensitization, psychosocial factors, and comorbid gynecologic, urologic, gastrointestinal, and musculoskeletal conditions. Diagnosis remains challenging, with up to half of cases lacking an identifiable pathology.
Aim: To summarize multidisciplinary approaches to the assessment and management of chronic pelvic pain, highlighting contributions from nursing, midwifery, physiotherapy, and allied health professionals.
Methods: This review integrates evidence-based clinical guidelines and research findings on CPP etiology, epidemiology, pathophysiology, evaluation strategies, differential diagnosis, and management. It draws from multidisciplinary perspectives to outline both physical and psychological interventions.
Results: CPP commonly coexists with conditions such as endometriosis, interstitial cystitis, IBS, and pelvic floor dysfunction. Central sensitization plays a key role in symptom persistence, with psychological comorbidities—such as anxiety, depression, and PTSD—frequently involved. Effective diagnosis requires comprehensive history-taking, physical examination, imaging, and functional assessment. Management is optimized through multimodal strategies, including pharmacologic therapy, pelvic floor physical therapy, cognitive behavioral therapy, nerve blocks, neuromodulation, and, when indicated, surgery. Interprofessional coordination significantly improves patient outcomes, reduces unnecessary interventions, and enhances long-term quality of life.
Conclusion: CPP requires a holistic, multidisciplinary approach addressing both somatic and psychosocial contributors. Tailored treatment plans, early specialist involvement, and patient education are critical to improving functional outcomes.
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Copyright (c) 2025 Amani Mubark Aldhaferi, Mariam Salman Hemad Alatawi, Maram Radhi Alanazi, Manar Radi Al-Anzi, Aisha Atwan Alshammari, Hind Hassan Ali Homadi, Abdullatif Ibrhim Zuayr, Sameer Ali Ibahim Zakri, Ahmed Abdullah Almalaq, Khadijah Hakami Ahmed Hatan, Fahad Nasser Ali Althurwi, Hend Fihaid Alshammari
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