When the pain does not go away – a case report on a comprehensive biopsychosocial physiotherapy approach for refractory vulvodynia treatment

Background: Vulvodynia is a chronic primary pain condition marked by persistent vulvar pain lasting more than three months, often accompanied by various potential contributing factors.Traditionally, it has been misunderstood as either solely a physical or psychological disorder.However, contemporary recommendations for managing persistent pain underscore the necessity of adopting a broader, patient-centered approach that extends beyond the conventional biomedical model. Aims:This case report aims to illustrate a comprehensive, biopsychosocial physiotherapy approach designed for the treatment of refractory vulvodynia.Case report: A 28-year-old woman sought help at the physiotherapy clinic, presenting with refractory vulvodynia and concurrent low back pain.Previous biomedically-focused interventions, including surgery, had proven ineffective.The presented physiotherapy approach centered on central pain mechanisms and encompassed patient-centered, values-based goals, pain neuroscience education, as well as local and global gentle manual therapy techniques and therapeutic exercises.