Myofascial Pelvic Pain

Spitznagle, Theresa Monaco; McCurdy Robinson, Caitlin

doi:10.1016/j.ogc.2014.04.003

Cited by 61 publications

(50 citation statements)

References 61 publications

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“…A recent review article emphasizes the role of the myofascial system in pelvic pain, a condition that has significant overlap with hip pain. 9 Also, trigger point injections into the musculature of the anteromedial hip appear to be effective at relieving the groin pain that accompanies chronic pelvic pain. 10,11 One case series (level IV evidence) reported a significant reduction in posterolateral hip pain in patients with confirmed acetabular labral tears after myofascial treatment.…”

Section: Myofascial Painmentioning

confidence: 99%

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging

Battaglia

D’Angelo

Kettner

2016

Journal of Chiropractic Medicine

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Objective: The purpose of this study was to present a narrative review of the literature of musculoskeletal causes of adult hip pain, with special attention to history, physical examination, and diagnostic imaging. Methods: A narrative review of the English medical literature was performed by using the search terms "hip pain" AND "anterior," "lateral," and "posterior." Additionally, specific entities of hip pain or pain referral sources to the hip were searched for. We used the PubMed search engine through January 15, 2016. Results: Musculoskeletal sources of adult hip pain can be divided into posterior, lateral, and anterior categories. For posterior hip pain, select considerations include lumbar spine and femoroacetabular joint referral, sacroiliac joint pathology, piriformis syndrome, and proximal hamstring tendinopathy. Gluteal tendinopathy and iliotibial band thickening are the most common causes of lateral hip pain. Anterior hip pain is further divided into causes that are intra-articular (ie, labral tear, osteoarthritis, osteonecrosis) and extra-articular (ie, snapping hip and inguinal disruption [athletic pubalgia]). Entrapment neuropathies and myofascial pain should also be considered in each compartment. A limited number of historical features and physical examination tests for evaluation of adult hip pain are supported by the literature and are discussed in this article. Depending on the clinical differential, the gamut of diagnostic imaging modalities recommended for accurate diagnosis include plain film radiography, computed tomography, magnetic resonance imaging, skeletal scintigraphy, and ultrasonography. Conclusions: The evaluation of adult hip pain is challenging. Clinicians should consider posterior, lateral, and anterior sources of pain while keeping in mind that these may overlap. (J Chiropr Med 2016;15:281-293)

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Section: Myofascial Painmentioning

confidence: 99%

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging

Battaglia

D’Angelo

Kettner

2016

Journal of Chiropractic Medicine

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“…Typical office examinations for women with urinary urgency, frequency, and dysuria include measuring the post‐void residual to ensure bladder emptying, a screening urinalysis, a urine culture, and a gynecological pelvic examination. An often overlooked part of the physical examination is assessment of the pelvic floor musculature that can lead to a diagnosis of pelvic myofascial pain …”

Section: Introductionmentioning

confidence: 99%

“…An often overlooked part of the physical examination is assessment of the pelvic floor musculature that can lead to a diagnosis of pelvic myofascial pain. 3 Myofascial pain syndrome has been defined by the presence of muscular pain associated with myofascial trigger points. 4 Pelvic floor myofascial pain (PFMP) is elicited during a gynecological examination by the examiner who directs pressure on muscles of the pelvic floor.…”

Section: Introductionmentioning

confidence: 99%

Pelvic floor myofascial pain in patients with symptoms of urinary tract infection

Wolff

Joyce

Brincat

et al. 2019

Intl J Gynecology & Obste

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Objective To correlate lower urinary tract symptoms typically associated with a urinary tract infection (UTI) with physical examination findings of pelvic floor myofascial pain (PFMP). Methods This retrospective review included all new patients presenting to a urogynecology clinic between August 2 and December 19, 2016. Patients completed validated questionnaires, had a catheterized urine specimen, and underwent pelvic examination. Associations between demographics, symptoms, urine culture, and PFMP were analyzed. Results We included 250 patients with urinary frequency (n=160, 64.0%), urgency (n=155, 62.0%), urgency incontinence (n=140, 56.0%), pelvic pain (n=43, 17.2%), and dysuria (n=25, 10.0%). PFMP was detected in 125 (50.0%) patients and culture‐proven UTI in 15 (6.0%) patients. Demographics associated with PFMP were lower prolapse stage (P<0.001), age younger than 50 years (P<0.001), lower parity (P=0.028), and non‐white ethnicity (P=0.003). Symptoms associated with PFMP were dysuria (adjusted odds ratio 4.13, 95% confidence interval 1.08–15.78), urgency/frequency (2.72, 1.47–5.04), and patient‐reported pelvic pain (2.57, 1.08–6.12). These symptoms were independent predictors in multivariable logistic regression analysis. Conclusions Most patients had symptoms associated with UTI; however, culture‐confirmed diagnosis was infrequent and PFMT was diagnosed in half of participants. Clinicians treating women with these symptoms are advised to examine the pelvic floor muscles.

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“…The costs of CPP may be growing because the conditions that cause CPP are commonly multifactorial and the parameters for defining the population are poorly reported. Pain in the pelvic region can arise from both visceral and somatic structures including the gynecologic, urologic, gastrointestinal, and musculoskeletal systems . Pain and dysfunction caused by somatic structures of the musculoskeletal system are often considered as a diagnosis of exclusion following negative testing and negative response to treatment of the pelvic viscera .…”

Section: Introductionmentioning

confidence: 99%

A Narrative Review of Musculoskeletal Impairments Associated With Nonspecific Chronic Pelvic Pain

Harris‐Hayes

Spitznagle

Probst

et al. 2019

PM&R

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The purpose of this narrative review is to present the evidence relating to musculoskeletal impairments found in people with nonspecific chronic pelvic pain (CPP). The musculoskeletal impairments assessed in this review include pelvic floor muscle: performance, resting state, strength, activation, posture and movement patterns. A search was performed systematically using PubMed, Cochrane, CINAHL, Embase, and Web of Science databases from 1998 to 2018 to identify studies reporting the relationship between nonspecific CPP and musculoskeletal impairments of the hip, pelvis, and trunk. The search resulted in 2106 articles that were screened by two authors. Remaining articles were screened by an additional two authors for inclusion in this review. Thirty‐one articles remained after initial screening. Full‐text publications were reviewed and an additional 25 articles were excluded. Six additional articles were located through review of the reference lists of included articles. The final review included 12 publications. Seven of these studies were cross‐sectional cohorts or case‐control comparing patients with CPP to asymptomatic controls. The level of evidence for the studies included in this review was low at Levels 4 and 5. We were unable to draw clear conclusions regarding the relationships of musculoskeletal impairments and CPP because validity and use of terms and assessments were inconsistent. Further research is needed with standardized definitions and measurements to better understand the musculoskeletal system as it relates to nonspecific CPP.

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Myofascial Pelvic Pain

Cited by 61 publications

References 61 publications

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging

Pelvic floor myofascial pain in patients with symptoms of urinary tract infection

A Narrative Review of Musculoskeletal Impairments Associated With Nonspecific Chronic Pelvic Pain

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