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Pelvic pain. A SAFE approach.

V I Rickert1, K J Kozlowski

  • 1Department of Pediatrics, Mount Sinai School of Medicine, Mount Sinai Hospital-NYU Health, New York, USA. vaughn_rickert@smtplink.mssm.edu

Obstetrics and Gynecology Clinics of North America
|February 29, 2000
PubMed
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The SAFE approach offers a practical way for gynecologists to manage chronic pelvic pain by addressing both physical and psychological factors. This method improves pain, function, and employment, even without a full multidisciplinary team.

Area of Science:

  • Gynecology
  • Pain Management
  • Psychosomatic Medicine

Background:

  • Multidisciplinary management effectively treats chronic pain, including chronic pelvic pain (CPP).
  • A randomized trial showed multidisciplinary care superior to traditional medical approaches for CPP.
  • Many gynecologists lack access to multidisciplinary settings, necessitating alternative strategies.

Purpose of the Study:

  • To introduce the SAFE (Simultaneous Assessment of Functional and Etiological factors) approach for managing CPP.
  • To provide a practical framework for gynecologists to address complex CPP cases.
  • To improve patient outcomes in pain severity, functional health, and employment.

Main Methods:

  • The SAFE approach involves regular, time-limited visits focusing on treatment compliance and identifying pain-reducing strategies.

Related Experiment Videos

  • Gradual spacing of visits from weekly to bimonthly/monthly intervals.
  • Coordination of care with physical therapists and mental health providers when feasible.
  • Focus on patient-reported improvements in pain and daily functioning, reinforcing medication adherence.

    • Main Results:

    • The SAFE approach facilitates simultaneous evaluation of nonorganic and organic pain components.
    • Structured, time-limited visits enhance treatment compliance and identify effective pain management strategies.
    • Integration with physical therapy and mental health support can further optimize outcomes.
    • Reinforcing small improvements in pain and function leads to greater daily improvements.

    Conclusions:

    • The SAFE approach is a viable strategy for gynecologists to manage chronic pelvic pain effectively within typical practice constraints.
    • This method allows for a comprehensive assessment and management plan addressing the multifaceted nature of CPP.
    • Focusing on patient engagement, adherence, and incremental improvements can lead to significant positive changes in quality of life.