Radiofrequency Versus Myofascial Therapy in Women With Myofascial Chronic Pelvic Pain: A Randomized Clinical Trial

Chronic pelvic pain (CPP) affects 5.7-26.6% of women and can severely affect quality of life (QoL). When combined with myofascial syndrome, CPP is often more severe and challenging to manage. Myofascial manual therapy (MMT) is the standard conservative treatment, whereas capacitive-resistive monopolar radiofrequency (RF) may be an effective alternative based on benefits seen in other musculoskeletal disorders. However, its standalone efficacy in women with CPP and a myofascial syndrome has not been established.

In this randomized controlled trial at a tertiary university hospital, women with CPP and myofascial syndrome were assigned to on-RF (active RF), off-RF (sham RF), or MMT. The on-RF and off-RF groups were double-blinded, with both participants and the physiotherapist unaware of device activation. A fourth group, no treatment, served as an observational control. Pain intensity, QoL, and sexual function were assessed at baseline and post-intervention. Statistical analyses included within-group pre-post comparisons and between-group differences using ANOVA with Tukey post hoc tests.

A total of 80 women were included in the study (20 per arm). The on-RF group demonstrated the greatest reduction in pain (mean decrease 3.98 points on the NRS, 95% CI 2.85 to 5.10; p < 0.001). Significant changes in QoL were observed in both RF groups, whereas no statistically significant differences were found in sexual function. Between-group analysis showed that on-RF reduced pain more than off-RF (mean difference -2.1, 95% CI -3.3 to -0.8; p = 0.002) CONCLUSIONS: Radiofrequency (RF) therapy significantly reduces pain in women with CPP and myofascial syndrome compared with off-RF, MMT, or no treatment. Further studies should evaluate long-term outcomes and optimal treatment parameters.