The Pelvis and Beyond: Musculoskeletal Tender Points in Women With Chronic Pelvic Pain

Overview

Journal Clin J Pain

Specialties Neurology
Psychiatry

Date 2015 Oct 23

PMID 26491938

Citations 16

Authors

Tatiana V D Sanses

Gisela Chelimsky

Noel P McCabe

Denniz Zolnoun

Jeffrey Janata

Robert Elston

C A Tony Buffington

Pippa Simpson

Liyun Zhang

Thomas Chelimsky

Affiliations

Soon will be listed here.

Abstract

Objective: To determine the feasibility of a detailed pain sensitivity assessment using body-wide musculoskeletal tender points (TPs) in women with different types of chronic pelvic pain (CPP) and compare phenotypic differences.

Materials And Methods: Seventy women with CPP and 35 pain-free women underwent musculoskeletal evaluation of TPs in the pelvic floor, abdomen, groin, inner thigh, and all 18 fibromyalgia TPs. Patients scored elicited pain on a numeric rating scale. TP pain scores were used for intergroup comparison and intragroup correlation.

Results: Women with CPP were grouped as having either bladder pain syndrome (BPS, n=24) or myofascial pelvic pain (MPP, n=11) singularly or both concomitantly (BPS+MPP, n=35). TP pain scores for all evaluations were higher in women with CPP compared with healthy women (P<0.001). Women with BPS+MPP had elevated TP pain for each evaluation compared with women with BPS alone. Pelvic floor and fibromyalgia TP scores correlated strongly in the MPP group, moderately in the BPS+MPP group, and weakly in the BPS alone group. Although some moderate and strong correlations between different body locations were present in all 3 groups, only the BPS+MPP group showed moderate to strong correlations between all body TPs.

Conclusions: Detailed musculoskeletal evaluation of women with CPP is feasible and well tolerated. Careful phenotyping differentiated BPS, MPP, and BPS+MPP groups. Attending to the differences between these groups clinically may lead to more effective treatment strategies and improved outcomes for patients with CPP.

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