Pain and functionality improved when underlying neuromuscular dysfunction addressed in chronic pelvic pain patients
Janaki Natarajan1,2, Tayyaba Ahmed1,2, Soha Patil1,2
1Department of Physical Medicine and Rehabilitation, Pelvic Rehabilitation Medicine Clinical Research Foundation, West Palm Beach, Florida, USA.
Aim:
Examine the effects of treating underlying neuromuscular dysfunction in chronic pelvic pain (CPP) patients.
Methods:
A retrospective longitudinal study of 200 female and male patients with CPP was performed upon an Institutional Review Board (IRB) approval (IRB# 17-0761). The outpatient protocol consisted of ultrasound-guided trigger point injections to the pelvic floor musculature with peripheral nerve blocks once a week for 6 weeks in an outpatient setting. Pelvic pain and functionality were measured before and after treatment using the Visual Analogue Scale and the Functional Pelvic Pain Scale. Functionality categories assessed were intercourse, bladder, bowel, working, walking, running, lifting, and sleeping.
Results:
Pretreatment, mean VAS score was 6.44 (standard deviation [SD] = 2.50; p < 0.05, 95% confidence interval [CI] = 6.09-6.79). Posttreatment mean VAS score was 4.25 (SD = 2.63; p < 0.05, 95% CI = 3.88-4.61). The mean FPPS score before treatment was 10.77 (SD = 6.39; p < 0.05, 95% CI = 9.88-11.65). Posttreatment mean FPPS score was 7.42 (SD = 5.87; p < 0.05, 95% CI = 6.61-8.23). Analysis of subcategories within FPPS indicated statistically significant improvement in the categories of intercourse, working, and sleeping.
Conclusion:
Findings show the treatment was efficient at decreasing pain in CPP patients. Results show promise for improving overall pelvic functionality, particularly within the categories of intercourse, sleeping, and working.
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