The Effectiveness Of Trigger Point Treatment In Chronic Pelvic Pain; A Pilot Randomised Controlled Trial

Abstract

Objective To investigate the effectiveness of ischemic compression and low-level laser therapy methods combined with exercise on the myofascial trigger points in women with Chronic Pelvic Pain and to determine which method is more effective.

Methods It was a parallel designed, single-blind pilot randomized clinical trial. Patients were recruited at physiotherapy laboratory of the Istanbul University from September 2017 to June 2019. Twenty-eight women patients with Chronic Pelvic Pain were included into the trial. Patients were randomized into two groups. Group 1 received ischemic compression and Group 2 received low-level laser therapy twice a week for 6 weeks. Both groups received the same standard exercise program. Pain, range of motion, pelvic floor symptom severity, quality of life, satisfaction, anxiety, and depression were assessed after 6 weeks, and 1-year follow up.

Results Following the treatment, significant differences were observed within both group subjects in pain, range of motion, symptom severity, quality of life, and anxiety-depression (p<0.05). This significant improvement in pain, symptom severity, symptoms related quality of life and pain subgroup of Short Form 36, continued after 1-year follow up (p<0.05). In comparison between group, Group 1 have more significant improvement than Group 2 in terms of symptoms related quality of life (p<0.05).

Conclusion Both methods have shown efficacy and can be used safely in chronic pelvic pain patients. Because it is more effective on symptoms related quality of life, the ıschemic compression method may be preferred for primary use.

Zusammenfassung

Fragestellung Ziel der Studie war es, die Wirksamkeit der ischämischen Kompression und der Low-Level-Lasertherapie in Kombination mit Übungen auf die myofaszialen Triggerpunkte bei Patientinnen mit chronischen Unterbauchschmerzen (chronic pelvic pain, CPP) zu prüfen und zu ermitteln, welches Verfahren wirksamer ist.

Methodik Es handelte sich um eine einfachblinde, randomisierte, klinische Pilotstudie mit Parallelgruppendesign. Die Rekrutierung der Patientinnen erfolgte im Physiotherapie-Labor der Universität Istanbul von September 2017 bis Juni 2019. Insgesamt wurden 28 Patientinnen mit chronischen Unterbauchschmerzen in die Studie aufgenommen und randomisiert in zwei Gruppen eingeteilt: Gruppe 1 wurde mit ischämischer Kompression und Gruppe 2 mit Low-Level-Lasertherapie zweimal wöchentlich über sechs Wochen behandelt. In beiden Gruppen kam dasselbe Standardübungsprogramm zur Anwendung. Schmerz, Bewegungsumfang, Schweregrad der Beckenbodensymptome, Lebensqualität, Zufriedenheit, Angst und Depression wurden nach 6 Wochen und bei der Nachuntersuchung nach einem Jahr erhoben.

Ergebnisse Nach der Behandlung fanden sich statistisch signifikante Unterschiede bei den Patientinnen beider Gruppen für die Parameter Schmerz, Bewegungsumfang, Schweregrad der Symptome, Lebensqualität und Angst/Depression (p<0,05). Die signifikante Verbesserung in den Bereichen Schmerz, Schweregrad der Symptome und symptombezogene Lebensqualität sowie in der Schmerz-Subgruppe im SF-36-Fragebogen zum Gesundheitszustand hielt bei der Kontrolle nach einem Jahr noch an (p<0,05). Im Vergleich der beiden Gruppen findet sich in Bezug auf die symptombezogene Lebensqualität in Gruppe 1 eine deutlichere Besserung als in Gruppe 2 (p<0,05).

Schlussfolgerung Für beide Verfahren konnte die Wirksamkeit und Sicherheit bei Patientinnen mit chronischen Unterbauchschmerzen nachgewiesen werden. Aufgrund ihrer besseren Wirksamkeit in Bezug auf die symptombezogene Lebensqualität kann die ischämische Kompression als primäres Verfahren in der Therapie angewandt werden.

Key words

chronic pelvic pain - myofascial trigger points - ischemic compression - low-level laser therapy - pain management

Schlüsselwörter

Chronische Unterbauchschmerzen - chronische Beckenschmerzen - myofasziale Triggerpunkte - ischämische Kompression - Low-Level-Lasertherapie - Schmerztherapie

Publikationsverlauf

Eingereicht: 21. September 2022

Angenommen: 24. Dezember 2022

Artikel online veröffentlicht:
28. Februar 2023

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