The Stanford Protocol is a therapeutic program developed in 2005 by David Wise, Ph.D., a psychologist and urologist Rodney U. Anderson, both of whom are active at Stanford University School of Medicine in Canada, to offer innovative support to people who have long suffered from pain in the pelvic area. Pelvic pain, often constant, at times intense, severely limits the quality of life of sufferers. The first step to succeed in overcoming an often disabling condition, fueled by a feeling of helplessness in the face of a problem that often drags on for years without a solution, is to rely on health professionals with expertise in the field to lay out an intervention program that often moves on several fronts by taking into consideration multiple aspects of the problem in order to have real resolving efficacy
Stanford Protocol: a multidisciplinary treatment approach
From the nervous system to the muscular system
The creators of the method began by noting that for decades chronic pelvic pain syndromes, from which Wise himself suffered for more than two decades, have been addressed with mostly pharmacological therapies and surgical procedures with little success, if not intended to make the problem worse. “Thus, at the basis of the protocol lies an important realization on the part of the two specialists,” comments the expert, “That is, in the understanding that the pelvic floor dysfunction that results in the painful condition is not related to a specific pathology in the uterus rather than in the bladder but to a chronic muscle contracture.” Classical treatments overlook the fact that pelvic floor dysfunction is both a systemic and a local problem. Systemic in that the overexcited nervous system produces pain. And local since anxiety and worry exacerbate localized pain that, in a vicious cycle, exacerbates pelvic floor problems and increases painful sensation
Working on multiple fronts
The Stanford protocol, which the two authors described in the book “A Headache in the Pelvis” now in its sixth edition, thus aims to teach chronic pelvic pain sufferers to relax and rehabilitate their pelvic floor muscles and together decrease the nervous arousal that fuels and consolidates the pain itself.
For this very reason, the protocol is divided into a part devoted to physiotherapy treatment, which patients after an initial period with professionals should be able to self-administer, and an additional part devoted to relaxation that aims to reduce the impact of the negative thoughts that accompany chronic pelvic pain syndrome and “turn off” the excitation of the nervous system to break the pain spiral
The goals and results
“The final landing place of the Stanford protocol, which today is often referred to as the Wise-Anderson protocol from the name of the two creators, is obviously to reduce pain but also to improve in toto the condition of life of those who accuse pelvic problems leading the person to feel better as a whole, more vital physically but also more serene and purposeful psychologically,” the expert clarifies.
“A goal that is achieved through an individualized program: each patient receives a tailored treatment plan designed around his or her specific problems and needs, which may include pelvic physiotherapy to relax tense muscles, relaxation techniques and stress management, psychological support to deal with pain-related anxiety or depression, and the use of medication when necessary.” Discouraging the heavy use of medication is, moreover, one of the cornerstones of the protocol, which as shown in a 2015 study leads after six months of treatment to a voluntary reduction in the use of painkillers. A subsequent study found significant improvement in pain status in both men and women involved in the protocol over a six-month period.