Trigger Points, Pressure Pain Hyperalgesia, and Mechanosensitivity of Neural Tissue in Women with Chronic Pelvic Pain

Abstract

Objectives

This study aims to evaluate the presence of myofascial trigger points (TrPs), widespread pressure pain sensitivity, and mechanosensitivity of neural tissue in women with chronic pelvic pain.

Design

Case-control study.

Setting

Faculty of Health Sciences.

Subjects

Forty women with chronic pelvic pain between age 18 and 60 years and 40 matched healthy controls were included in the study.

Methods

TrPs were bilaterally explored in gluteus maximus, gluteus medius, gluteus minimus, quadratus lumborum, and adductor magnus muscles. The referred pain reproduced lumbopelvic symptoms. Pressure pain thresholds (PPTs) were also bilaterally assessed over the Pfannenstiel incision point on the abdominal, C5-C6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle. Mechanosensitivity of neural tissue was assessed with the neurodynamics tests of slump and the straight-leg raising.

Results

Significant between-group differences were found in TrP presence in patients with chronic pelvic pain (P < 0.001) compared with those included in the control group. Widespread pressure pain hyperalgesia was also found, with PPTs significantly reduced in the points assessed. Neurodynamics show a significantly decreased value in women with CPP.

Conclusions

Patients with chronic pelvic pain presented a high percentage of TrPs that reproduce their symptoms. Patients also showed a widespread pressure pain hyperalgesia and more mechanosensitive neural tissue due to a decrease on the range of motion related to neurodynamics.

 Myofascial Pain Syndrome, Pressure Algometry, Neurodynamics, Chronic Pelvic Pain