Aetna considers the following treatments medically necessary for members with vulvodynia/vulvar vestibulitis: Physical therapy Perineoplasty

Clinical Policy Bulletin: Vulvodynia and Vulvar Vestibulitis Treatments

Clinical Policy Bulletin: Complex Regional Pain Syndrome (CRPS) / Reflex Sympathetic Dystrophy (RSD): Treatments

Number: 0447 (Replaces CPB 550) Policy I. Aetna considers continuous epidural analgesia medically necessary for the treatment of members with intractable complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD), when all of the following selection criteria are met: ■ Members have experienced pain for more than 3 months despite conservative therapy (e.g., exercises...

Clinical Policy Bulletin: Vulvodynia and Vulvar Vestibulitis Treatments

Vulvodynia and vulvar vestibulitis: challenges in diagnosis and management.

Vulvodynia is a problem most family physicians can expect to encounter. It is a syndrome of unexplained vulvar pain, frequently accompanied by physical disabilities, limitation of daily activities, sexual dysfunction and psychologic distress. The patient's vulvar pain usually has an acute onset and, in most cases, becomes a chronic problem lasting months to years. The pain is often described as...

Complex Regional Pain Syndrome (CRPS) / Reflex Sympathetic Dystro..

II. Aetna considers sympathetic blocks (e.g., stellate ganglion block [cervical sympathetic block] and lumbar sympathetic block) medically necessary for the treatment of CRPS when conservative treatments, including analgesia and physical therapy, have failed. Up to 3 sympathetic blocks are considered medically necessary to diagnose a member's pain and achieve a therapeutic effect; if the member...