Transcript of VPS Podcast 4 - Physiotherapy treatment for vulval pain: a presentation given by Helen Forth

Slide 25 (32:13)    Physiotherapy for vulval pain: does it work?

So, just very quickly: does it work? Because I think you’re probably very interested in that.

Slide 26 (32:19)    Does physiotherapy work?

There is gathering evidence, and increasing evidence all the time about the effectiveness of physio. The effectiveness of EMG biofeedback has been very widely documented, particularly by Howard Glazer, who’s a chap who’s based out in the States – some of you may have even made the trip over to see him. That’s where a lot of this work started, actually, it was looking at the effectiveness of biofeedback into pelvic floor rehabilitation. I feel quite strongly that physiotherapy is more than just biofeedback: it’s often a big part of what we do with you, but as you’ve hopefully gathered from the other things that I’ve talked about, there is an awful lot more that we can do that can benefit when you’ve got vulval pain. In terms of some studies that have been done in the not too distant past, there’s been a couple quite recently that have been published that have shown benefit. They’re quite small studies. My study that I’ve mentioned there was a pilot study – as I said before, it was part of my Master’s research, so very small scale, but showed really encouraging results in terms of the effectiveness of a physio approach to treating vulval pain.

Slide 27 (33:29)    Does physiotherapy work? (continued)

There are more and more studies coming out which are showing the additive effect of combining biofeedback with other methods. This is what I alluded to when I said I feel like physiotherapy is more than just biofeedback, and in fact the research is starting to show that as well, that a combined approach is the most effective way to treat these kinds of pain syndromes. So, it may be that that includes some CBT, some psychosexual counselling, obviously working alongside your gynaecologist for topical creams or medications if those are indicated. But as I said, most papers to date are small scale, and they’re not generalisable, but I think it’s a good start in terms of showing the effectiveness anyway.

Slide 28 (34:13)    Conclusion

Conclusion? There is a wide and diverse role for physiotherapy in treating vulval pain. We are able to offer a multifaceted assessment and treatment approach to vulval pain and the coexisting or contributing factors. The effectiveness is beginning to be shown and recognised. The research and the media interest is increasing and we’ve heard Channel 4 are interested, which is fantastic, but there is limited availability of treatment with specialist physiotherapists, and I will acknowledge that – we’re trying to do something about it in terms of the courses that are available and the training that’s available. But in terms of finding a Women’s Health Physiotherapist, I have just included the ACPWH website on the slide there. You can email somebody through the website who will provide you with a list of Women’s Health physiotherapists in your area. It may be that not all of those Women’s Health physiotherapists have experience in treating vulval pain, but hopefully they’ll be able to put you in touch with somebody who does, because we’re quite a small network, and most of us have got links elsewhere in the country, so we’re often able to direct patients accordingly.

Slide 29 (35:23)    Thank you!   

Thank you!