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January 13, 2009

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The article states, “During treatment, patients learn how to correct their movements, breathing patterns and posture," and that there were significant improvements in the Mensendieck therapy group. However, the article does not quantify the outcomes improved. Also, was it a synergistic effect of movement correction, breathing and posture that improved outcomes, or was it one of these variables alone that created the improved outcome?

This is great! I'm so glad that there is finally a movement towards a holistic approach to healing and understanding that the mind AND body are connected.

This is a great addition to pain management, as opposed to women being on medications for long periods of time. They could use Mensendieck as an adjunct therapy to enhance their treatment.

Can anyone say placebo effect? I’m not in the business of telling people that they should suffer just because I don’t happen to be a convert of holistic therapy, but I can’t help but feel a bit disheartened every time I come across a study like this. The research is difficult to take seriously when the condition treated is something as nebulous as pelvic pain of indeterminate origin, and the therapy tested didn’t emerge from any scientifically rigorous process. I find it difficult to condemn the beneficiaries of these methods, but a study like this is inadequate in telling us anything meaningful about the etiology of the pain or the mechanism by which this therapy relieves it and is, therefore, of very little scientific value.

Why were these women experiencing pelvic pain? Did the study only include women with pelvic pain due to a certain condition? I do agree that concentrating on posture, breathing and movements that can strengthen your body can help with pain. If they were able to deal with the pain with only these techniques and no medication, it can be very promising news since these are women suffering from chronic pelvic pain and it is not healthy to be on chronic pain medication.

Rogue,

I don't think the research purpose was to investigate the etiology of pelvic pain. Just as you pointed out, pelvic pain has an indeterminate origin. Currently, conventional practitioners do not even know what is causing this discomfort in women. So what they do is manage the pain. With this research, it gives those women additional options to consider for their pain rather than popping pills.

Is mind-body therapy being used in cancer patients to alleviate their pain? It is based on the same logic as pelvic pain.

I agree with Luce. Although this study is not conclusive enough to rule out the use of pain killers for pelvic pain, at least it provides these women with another option for managing their pain. I know that the placebo effect is undesired when trying to figure out the effectiveness of a therapy, such as somatocognitive therapy, but I can't help thinking that whatever the cause, it's great that the therapy was able to provide these women with some relief.

I wonder if Mensendieck therapy is comparable to Reiki, or energy healing?

This is a great addition to pain management as opposed to women being on medications for long periods of time, especially as the cause of this pain is still very unclear to physicians.

Daniel,

I did some read up on it, and this is what I found: Mensendieck therapy is a paramedical treatment method that is specialized in posture and movement. Therapists concentrate on improving the patient’s posture and movement habits.

I hadn’t heard of Mensendieck therapy before, and a quick web search brought up many Web sites -- all in Dutch. The translations seemed to indicate that it was a form of physical therapy, a relearning of correct posture practices. If this type of therapy relives pain, then the participants must have continued with the better posture and breathing practices, and so the effects continued. Sounds really interesting! I wonder if this therapy is available in the US at all?

This is a great alternative to medicating patients with pain since the source of the pain is idiopathic and still needs to be researched.

The more alternative medicine places that I attend, the more I see that people truly believe in what they do. The connection between the mind and body needs to be one in order to resolve the issues in the body.

This is great news for people with chronic pain. I'm sure they feel that they will never get rid of the pain or never stop taking medications. The only hard part is that most of the time health insurance doesn't cover these treatments and they are expensive.

Mensendieck therapy seems to be related to posture and body alignment, so it would make sense that these women would likely benefit from pilates as well. I think the key here (and always!) is to start and maintain exercise early, which will hopefully help prevent pelvic pain in the first place. By regularly attending to your body, you can keep it healthier for longer!

I really don't think this is a placebo. Intuitively, it makes a lot of sense. The way we walk, sit and stand all affects the pelvis. This is a great alternative therapy; perhaps not as monotherapy, but maybe as an adjunct. I would like to see another study, one with more objective measurements.

As I was reading this, I cannot help but also consider the possibility of the placebo effect. There was a control group, but was this study double-blinded? If this study was double-blinded, then in theory the placebo effect may also show improvement in the control group? If I was a subject and I was told that Mensendieck somatocognitive therapy may improve my symptoms, then I may be biased in terms of reporting the severity of my symptoms.

This is a wonderful thing, as so many women suffer incessantly from chronic pelvic pain. They say many chronic pain sufferers experience a disconnection between their somatic senses and their bodies. It is my understanding that acupuncturists strive to manipulate nerve endings to connect/disconnect certain pain pathways. Oftentimes, this also has a physiological affect beyond pain management. Is Mensendieck somatocognitive therapy somewhat like acupuncture? It would interesting to find out the similarities.

I did some digging and found the paper for the study. However, after reading it I don’t really see the difference between this method and other physical therapy approaches. “Correcting movements, breathing pattern, and postures” sounds a lot like Pilates or yoga to me.

Throughout the study, there was no mention on the “mind” part of this therapy. If Mensendieck therapy is supposed to be the “body” part of this dual mind-body therapy, then where is the physical treatment of this study? There was mention of psychological exams to rule out depression and other conditions, but there was no special treatment to these study subjects.

There would need to be another follow-up study, or methods of this study would have to be more defined in order to determine if this mind-body therapy is worth looking into.

Body pains are generally ignored by us, thinking that these are very common and silly incident and not serious enough to pay for a doctor. Pain signals are processed in the brain - so it has to be involved somehow. Anxiety and depression have been linked to back pain.

The key to improving your back symptoms and your emotional state lies in your ability to rekindle your sense of control and personal power.

Have these guys re-invented yoga 4,000 years later, or am I missing something?

Tamara said "I know that the placebo effect is undesired when trying to figure out the effectiveness of a therapy."

I disagree. The placebo effect is a measure of how good the body can be at healing itself if the mind believes it can. Just look at the work of Deepak Chopra, Brandon Bays and Dr David Hamilton.

I think there is so much potential for us to use the power of our imagination and mind, using techniques such as hypnosis and visualization. Also, I believe that many people are not aware of their body, their posture, their feelings. We don't tend to make time to focus inward in our busy modern lives and yet it is so, so important. It doesn't have to be 'full on' meditation, but a sensible self awareness can certainly help us in so many areas of our lives. Other people read our body language - it is high time we be more aware of our own! Our mind is giving us telltale signals all the time - if we would just pay more attention we could live more of the life we want than one we play a 'bit part'in.

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