Physical therapy evaluation of patients with chronic pelvic pain: a controlled study

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.

Key words: diagnostic test, myofascial pain, pelvic floor, pelvic pain