Outpatient neuromuscular protocol may improve the quality of life in women with chronic pelvic pain

The assistance of neuromuscular therapies to conventional therapy methods for women with pelvic pain

Key Points

Highlights:

• A multidisciplinary pain control package including physical therapy and neuromuscular treatment approach may improve pain symptoms of women with chronic pelvic pain.

Importance:

• Neuromuscular treatments and physical therapy may be important in the finalization of proper pain management of women with chronic pelvic pain. including endometriosis.

What's done here:

• Among women who have been referred to pelvic pain rehabilitation outpatient clinics (n=186) with a diagnosis of chronic pelvic pain, patients with "chronic pelvic pain syndrome have been included.
• Patients have completed the Visual Analogue Scale (VAS) or Functional Pelvic Pain Scale (FPPS) questionnaires.
• An ultrasound‐guided peripheral nerve block and trigger point injections to pelvic floor muscles together with pelvic floor physical therapy once weekly for 6 weeks and home treatment with yoga poses have been applied to all patients.
• The working, intercourse, sleeping, walking, running, lifting, bladder, and bowel functions have been identified to analyze improvement.

Key Results:

• Both VAS and total FPPS scores showed an improvement after treatment.
• The analysis of functional improvement showed statistical changes in the quality of working, intercourse, and sleeping on the 3rd-month follow-up after the completion of the treatment.

Limitations:

• The study was designed retrospectively without allowing a randomized controlled trial. Thus, the possible placebo effect cannot be excluded.

Lay Summary

Chronic pelvic pain syndrome is a complicated entity causing central and peripheric sensitization of nerves. The sensitization processes start a loop of unbreakable pain chain causing resistance to conventional therapy methods.

The study conducted by Soha Patil et al covering data from 9 centers all around the USA has analyzed the effect of neuromuscular treatment approaches on the improvement of life quality of women with chronic pelvic pain.

The authors have included 186 patients of whom 56 were diagnosed with endometriosis only while the rest had some other pain-related comorbidities. They have applied a 6-week treatment program including peripheral nerve block and trigger point injections to pelvic floor muscles together with pelvic floor physical therapy. Visual Analogue Scale (VAS) or Functional Pelvic Pain Scale (FPPS) questionnaires before and 3 months after the completion of the treatment.

Pain scores revealed an improvement. The analysis of functional improvement showed statistical changes in the quality of working, intercourse, and sleeping on the 3rd-month follow-up after the completion of the treatment. While the study had a retrospective nature without giving a chance to placebo control, the authors highlighted the visible improvement of the life quality of those women and suggested a multidisciplinary approach to all women with pelvic pain.

Research Source: https://pubmed.ncbi.nlm.nih.gov/34529875/