A Headache in the Pelvis: A New Understanding and Treatment for Chronic Pelvic Pain Syndromes
by David Wise, Rodney Anderson
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Book Summary Information
Author: David Wise, Rodney AndersonEdition: Perfect Paperback
Audio: English (Unknown); English (Original Language); English (Published)
Published: 2010-04-01
ISBN: 0972775552
Number of pages: 520
Publisher: National Center For Pelvic Pain
Book Reviews of A Headache in the Pelvis: A New Understanding and Treatment for Chronic Pelvic Pain Syndromes
Book Review: Ineffective and Unscientific
Summary: 1 Stars
Pelvic pain can have a devastating affect on a persons life and when I first read Headache in the Pelvis I was filled with hope. This book offered me my ticket back to a healthy, pain free life. After finishing the book I was eager to attend the clinic and almost immediately phoned the author and booked a place to attend the clinic.
After attending the clinic I diligently practised the protocol described in the book for more than a year. I would stretch, have hot baths , practice the relaxation methods taught to me and also have trigger point therapy performed on me all as described in the book and practiced at the clinic. In the first few months I was full of enthusiasm and even recommended the book to other patients. However as the months passed by my enthusiasm began to wane. I was not seeing the progress I hoped for. I still faithfully persevered with the protocol but after a year I still had not seen any significant progress. The protocol helped me deal with the pain but it was not reducing it at all. At first I thought it was just me that it had not worked for but after contacting other people who had also been to the clinic I found that they had not made progress either and had moved onto to try other treatment. After a year and a half I resigned myself to the fact that the protocol was ineffective.
In my opinion when you suffer from chronic pelvic pain your desire to recover can cloud your judgement. This happened when I read this book for the first time and I was not objective in my appraisal of the book. I so wanted to become pain free that I pushed niggling doubts to the back of my mind. The book in some respect encourages you to do this. It says you must have faith in the treatment. The word faith implies that you must believe in something for which there is little or no evidence for. After a few read throughs of the book I realised that there are very real problems with Headache in the Pelvis. I would like to share just a few of them with you.
The first may seem trivial but it is the writing style of the book. As has been mentioned in another review on Amazon Wise and Anderson are not writers. The writing is awkward and the book uses tired twee phrases such as `when life gives you lemons make lemonade'. There is also the infantilising land of the pelvic floor story used to describe the condition to sufferers. As I have mentioned the book attempts to appeal to a person's faith and spirituality. This is fine in a self help book at Borders but should these words appear in a work of science? The book is apparently the result of 8 years work at Stanford ,one of the finest academic institutions in the country. I find it disconcerting that the authors after 8 years work produced such a poorly written book. It makes me suspicious of the length of time it actually took to produce.
The second is the authors way of arguing for the main theory of Headache in the Pelvis. A central premise of the book is that psychology creates pelvic pain, for example sexual abuse, guilt of cheating on a partner, anxiety, etc causes pelvic pain. So if we simplify this premise we can say A causes B. Now the correct scientific approach to this would be to try to collect all the evidence that suggests A does *not* cause B. If you cannot disprove your theory then there's a good chance it is correct. The book does not do this though. The authors instead look for all the evidence that suggests A does cause B. That's a recipe for believing any quack theory ever created.
I've heard of women who got pelvic pain after pregnancy, patients developing pelvic pain after a car crash, after an infection which has since resolved, from weightlifting, from falling badly, from hernias, nerve entrapments, etc. The authors appear to ignore these possibilities as this does not fit the theory, in other words these points suggest that A does not cause B. The book cannot be taken seriously as it does not want to confront the obvious flaws in its central theory. I have to say I have yet to meet a physical therapist who specializes in pelvic pain who believes in the central theory of this book.
I suspect the authors are making the classic mistake of all bad science mistaking correlation for causality. Please find me a person with pelvic pain for which there is no obvious diagnosis who is not anxious.
The authors are also fond of highlighting the fact that their protocol has been published in a Urology Journal. I was at first encouraged by this but in reality it is not that impressive. As a book called Bad Science by Ben Goldacre points out ` there have been an estimated fifteen million medical articles published so far, and 5000 journals are published every month.'' Are we to assume that every single article published is relevant and completely accurate in its findings? Just because something is published in a journal does not make it fact.
The book is written by a urologist and a PhD graduate. Admittedly its reassuring that the book is co authored by a urologist but I have to say I am not so impressed with a PhD qualification. I accept it takes a great deal of effort to obtain a PhD but as the book Bad Science again points out ` there are few opinions so absurd that you could not find at least one person with a PhD somewhere in the world to endorse them for you and similarly, there are few propositions in medicine so ridiculous that you could n't conjure up some kind of published experimental evidence somewhere to support them'' I have to say I would be curious to know what subject the authors PhD is in.
The book also contains no references. The reader is meant to blindly accept the claims of the authors. In addition most of these claims are speculation. The phrase ` we speculate' is common in the book. `We speculate' is a nice way of saying `well we don't have any evidence to support our claim but this is what we think'. The book bases most of its assumptions on a single experiment that showed electrical activity increases in a trigger point when a patient counts backwards which they suggest is a way of inducing anxiety. What is new about this finding? Its been known for some time now that anxiety can increase chronic pain but this experiment does not suggest that anxiety creates trigger points only that it increases activity within it. It also does not suggest that if you decrease anxiety you can eradicate a trigger point.
In my opinion when looked at objectively and rationally this book is a poor contribution to the study of pelvic pain. In my view the sixth edition is another money spinner for it's authors. The book is also described as 'ground breaking' and 'revolutionary'. I suspect this is just marketing for the book but if this is the case I would suggest the field of pelvic pain research is in serious trouble.
More A Headache in the Pelvis: A New Understanding and Treatment for Chronic Pelvic Pain Syndromes reviews:
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Summary of A Headache in the Pelvis: A New Understanding and Treatment for Chronic Pelvic Pain Syndromes
This groundbreaking book describes the Wise-Anderson Protocol for muscle-related pelvic pain in men and women, a new and revolutionary treatment developed at Stanford University. The Wise-Anderson Protocol involves the treatment of muscle-related pelvic pain and dysfunction, variously diagnosed as prostatitis, chronic pelvic pain syndrome, pelvic floor dysfunction, pelvic floor myalgia, interstitial cystitis, urethral syndrome, levator ani syndrome, among other related diagnoses affecting some twenty million men and women in the United States. Specifically, The 6th edition of A Headache in the Pelvis adds new research recently published in the Journal of Urology done by the Wise-Anderson team describing the relationship of painful trigger points that refer and re-create specific symptoms of pelvic pain, new research done at Stanford on the relationship between early morning anxiety and those with pelvic pain, and firsthand stories from women who have undergone the Wise-Anderson Protocol, along with other new sections.Pain Management Books
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