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

Am J Obstet Gynecol. 2008 Mar;198(3):272.e1-7. doi: 10.1016/j.ajog.2007.09.002.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chronic Disease
  • Cross-Sectional Studies
  • Diagnostic Tests, Routine
  • Female
  • Humans
  • Musculoskeletal Diseases / complications
  • Musculoskeletal Diseases / diagnosis
  • Pelvic Pain / etiology
  • Pelvic Pain / therapy*
  • Physical Therapy Modalities*
  • Prospective Studies