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Physical therapy evaluation of patients with chronic pelvic pain: a controlled study
Frank F Tu1, Jane Holt, Josephine Gonzales
1Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Objective:
The purpose of this study was to determine the relative frequency of positive musculoskeletal exam findings between patients with chronic pelvic pain (CPP) and healthy control subjects.
Study Design:
We conducted a masked, prospective, cross-sectional study of abnormal pelvic, abdominal, and back examination findings in 19 women with CPP vs 20 healthy control subjects.
Results:
Women with CPP had more frequent abnormal musculoskeletal findings than did control subjects asymmetric iliac crests (61% vs 25%), pubic symphysis heights (50% vs 10%), and positive posterior pelvic provocation testing (37% vs 5%; all P < .05). Patients with pain exhibited more tenderness at several abdominal muscle sites, had higher median total pelvic floor tenderness scores (3/24 vs 0/24; P < .05), and less control of the pelvic floor (unable to maintain 10 seconds of relaxation, 78% vs 20%; P < .001).
Conclusion:
The higher frequency of positive pelvic musculoskeletal findings in CPP suggests that an investigation of somatic pain generators is warranted in these patients.
