Complementary Approaches for Military Women with Chronic Pelvic Pain: A Randomized Trial

Carol D. Crisp, Robert Baldi, R.W. Baldi, Matthew Fuller, Eduardo Abreu, Andrea G. Nackley
Journal of integrative and complementary medicine · 2022 · vol. 29(1) , pp. 22–30 · doi:10.1089/jicm.2022.0616 · PMID:36251868 · W4306644808
RCT OA: closed CC0 ⤵ 1 in-corpus citation
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This randomized trial found that mindfulness-based stress reduction (MBSR) reduced chronic pelvic pain perception and depression in military women, while a healthy lifestyle intervention only reduced depression.

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Abstract

Introduction: Active duty (AD) women suffer with chronic pelvic pain (CPP) while providers tackle diagnoses and treatments to keep them functional without contributing to the opioid epidemic. The purpose of this randomized trial was to determine the effectiveness of noninvasive, self-explanatory mindfulness-based stress reduction (MBSR) or self-paced healthy lifestyle (HL) interventions on CPP in AD women. Methods: A 6-week, interventional prospective study with AD women aged 21-55 years at Mountain Home (MTHM), Idaho, was conducted. Women were randomly assigned to MBSR (N = 21) or HL (N = 20) interventions. The primary outcome was pain perception. The secondary outcomes were depression and circulating cytokine levels. Results: Women in the MBSR group exhibited reduced pain interference (p < 0.01) and depression (p < 0.05) alongside decreased interleukin (IL)-4 (p < 0.05), IL-6 (p < 0.05), eotaxin (p < 0.05), monocyte chemoattractant protein-1 (p = 0.06), and interleukin-1 receptor antagonist (IL-1ra) (p < 0.01) and increased vascular endothelial growth factor (p < 0.05). Women in the HL group did not have changes in pain; however, they did exhibit reduced depression (p < 0.05) alongside decreased granulocyte-macrophage colony-stimulating factor (p < 0.05) and increased tumor necrosis factor alpha (p < 0.05), stromal cell-derived factor-1 (p < 0.01), and IL-1ra (p < 0.01). Conclusions: AD women receiving MBSR or HL had reduced depression scores and altered circulating cytokine levels; however, only those receiving MBSR had reduced pain perception. Findings support MBSR as an effective and viable behavioral treatment for AD women suffering from CPP and provide premise for larger randomized controlled studies. Clinical Trial Registration: MOCHI-An RCT of mindfulness as a treatment for CPP in AD Women NCT04104542 (September 26, 2019).

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Condition tags

chronic_pelvic_pain

MeSH descriptors

Interleukin 1 Receptor Antagonist Protein Military Personnel Adult Cytokines Female Humans Middle Aged Pelvic Pain Pelvic Pain Prospective Studies Randomized Controlled Trials as Topic Stress, Psychological Stress, Psychological Vascular Endothelial Growth Factor A Young Adult

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