From Roots to Canopy: Understanding Chronic Pelvic Pain Through a Tree-Inspired Model.

Abstract

Introduction and hypothesis: Chronic pelvic pain affects approximately 25% of women. Despite its prevalence, health care providers often find it challenging and may feel underprepared to offer effective care.

Methods: Using the metaphor of a tree provides a simplified, systematic approach to better understanding and thus managing this condition. The tree model unites both the biopsychosocial and neuroinflammatory models of chronic pain. In this metaphor, the tree's roots represent nociceptive inputs, the trunk represents nociplastic changes, and the canopy signifies psychosocial factors. The bark symbolizes protective behaviors adopted by the individual, whereas the sap represents the bidirectional nature of pain messaging.

Results: This metaphor provides a relatable visual framework for understanding chronic, persistent pelvic pain and serves as a foundation for history taking, physical examination, and care planning. The tree metaphor can help patients understand their pain and serve as a starting point for discussing treatment options.

Conclusion: It helps to deconstruct the complexity of chronic, persistent pelvic pain into manageable components, offering a practical tool for both individuals with chronic pelvic pain and providers.