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

Pain Med. 2019 Jan 1;20(1):5-13. doi: 10.1093/pm/pnx206.

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.

Trial registration: ClinicalTrials.gov NCT01994343.

MeSH terms

  • Adolescent
  • Adult
  • Chronic Pain / physiopathology*
  • Female
  • Humans
  • Hyperalgesia / physiopathology*
  • Middle Aged
  • Myofascial Pain Syndromes / diagnosis
  • Myofascial Pain Syndromes / physiopathology
  • Pain Threshold / physiology
  • Pain, Referred / physiopathology
  • Pelvic Pain / diagnosis
  • Pelvic Pain / physiopathology*
  • Range of Motion, Articular / physiology
  • Trigger Points / physiopathology*
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT01994343