Because of the dearth of research examining the involvement of psychosocial factors in acute pelvic pain, this chapter focuses on chronic pain in the pelvic region, excluding abdominal pain. Although remarkably common in the female population, chronic pelvic pain (CPP) constitutes a broad and poorly-defined diagnostic category. Indeed, a recent survey of published studies noted that over 90% of investigators did not specify anatomical locations of pain beyond noting that it was ‘in the pelvic region’, and approximately three-quarters of published CPP studies included no information on whether physical pathology was present (Williams et al., 2004).
The most commonly utilized definition of CPP; ‘recurrent or constant pain in the lower abdominal region that has lasted for at least 6 months’, ignores aetiology (Zondervan & Barlow, 2000). The International Association for the Study of Pain (IASP) has also promulgated a definition for CPP without obvious pathology, but such terms have been criticized for drawing an artificial distinction between organic and non-organic pain (Grace, 2000). Current conceptualizations of pain generally utilize the IASP's definition of pain as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage’ (International Association for the Study of Pain, 1979). This inclusion of affect in the definition of pain has largely abolished old distinctions between ‘organic’ and ‘functional’ pain.