Shalini Wiseman
Chronic pelvic pain (CPP) is broadly classified as cyclical
and non-cyclical CPP. Non-cyclical CPP does not present
exclusively with symptoms of dyspareunia, dyschezia or
dysuria but can present with additional symptoms such as
suprapubic and lower abdominal pain, and painful pelvic
musculatures (1). The pain can worsen after pelvic floor
related activities such as coitus or voiding (2). Myofascial
pelvic pain (MFPP) is caused by the presence of myofascial
trigger points (MTrPs) in the pelvic muscles and the
pelvic floor muscles (PFM) and it can be the primary mediator
for non-cyclical CPP (4,5).
This study analysed trans-perineal trigger point dry needling
(TrDN) combined with manual therapy for the
PFM and compared it with manual therapy for non-cyclical
chronic pelvic pain (CPP).
The primary outcome reviewed the number of treatments
required within the allocated ten treatments to effect
improvement. The session where the participant ceased
treatment due to resolution was noted as the end point.
To evaluate the decrease in pain, the 0-10 Numeric Pain
Rating Scale (NPRS) was analysed at baseline, the tenth
treatment or earlier as per resolution.
Secondary outcomes reviewed dyspareunia, bladder and
musculoskeletal pain variables were evaluated with the
Female Sexual Function Index questionnaire (FSFI) and
an abbreviated version of the International Pelvic Pain
Questionnaire (IPPQ) pre-treatment and after the final
treatment.