A Questionnaire to aid history taking
Where possible, asking your patient to complete a questionnaire at home, before her appointment makes it easier to get the full history of her pain concerns. Completing it at home in her own time, allows her time to consider the answers carefully and collect important information, including details of any previous surgery. Using a questionnaire allows you to understand the main issues quickly and completely so that you can focus on the areas that concern her most. A suitable questionnaire is available below.
Where a patient with complex pain consults you unexpectedly, it may be best to address only immediate needs at that time, provide information to read and the pelvic pain questionnaire for her to complete at home. Then arrange another longer appointment on another day.
Introductory reading for your patient at home
By reading about pelvic pain before her visit, your patient will be better prepared for the time you have together. The attached small e – booklet is free and can be passed on to friends and family. It introduces the concept of different types of pain, a mix of treatments and encourages her to become an active partner in her health care.
She can read the more comprehensive book Endometriosis and Pelvic Pain E-book available for AUS $22 at http://www.pelvicpain.org.au/online-shop/
She can manage her acheing or stabbing pains with help from Pelvic Physiotherapist Patricia Neumann using her downloadable MP3 Audio available for AUS $22 at http://www.pelvicpain.org.au/online-shop/
An opportunity to bring a friend
Pain can be complex, and it may be difficult for her to take in all your advice when she feels unwell. Bringing a friend, partner or relative with her to her appointment means she will have someone to discuss your advice with after the appointment. This improves communication and involves those who are important in her life in her care.
Keeping track of progress
Making a list of her symptoms at the first visit makes it easier to track progress over time. During review visits, the original symptom list can be reviewed, with the opportunity to recognise problems that have been successfully managed and are no longer present, as well as identifying problems that still require attention.
How to manage her pain
The article below outlines a management plan you can use for your patients with pelvic pain.
(This article reproduced with permission, Medicine Today, 2013)
Remember that where pain is sudden or stabbing, a pelvic muscle component to the pain is usually present. This can cause difficulty moving when pain is severe. This site has information on how to recognise and manage pelvic muscle pain, stretches to help release tension in these muscles. A simplified view of the big picture of chronic pelvic pain. The video below with Dr Susan Evans outlines Chronic Pelvic Pain and current management techniques.
The following article explains how to prescribe neuropathic medications for chronic pain. Further information for individual medications is available on this site.
(This article reproduced with permission, O&G Magazine, Sept 2014 )
Further support for your patient with pelvic pain
– suggest that she considers LIKING the Pelvic Pain Foundation of Australia Facebook page to keep up to date with the latest in pelvic pain management, available resources and research projects she may wish to become involved with
– the Pelvic Pain Foundation holds events for women and men with pelvic pain, and to train GPs in this area. Check the Events page on this site.
Most aspects of pelvic pain can be managed in general practice, and with maybe 1 Million Australians affected, it is General Practitioners who will see the majority of patients with pelvic pain.