To Investigate the Use of Trans-perineal Trigger Point Dry Needling With Manual Therapy and to Compare the Outcome With Manual Therapy Treatment for Chronic Pelvic Pain With Dyspareunia. A Randomized Clinical Trial.
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Dyspareunia
- Sponsor
- Cork University Hospital
- Enrollment
- 79
- Locations
- 2
- Primary Endpoint
- Pain reduction or resolution within 10 treatment sessions, evaluated with the 0-10 Numeric Pain Rating Scale (0-10NPRS)
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Chronic Pelvic Pain (CPP) are around 10% of gynaecology referrals.Non-relaxing pelvic floor dysfunction (NRPFD) is an under-appreciated cause for CPP with dyspareunia where no other pathology exists. The effectiveness of manual therapy in studies have shown statistically significant pre and post treatment differences.However no study has reviewed the efficacy of inclusion of trans- perineal trigger point dry needling used with manual therapy for NRPFD. This study will investigate the effectiveness of trans-perineal trigger point dry needling used with manual therapy techniques for CPP.
Detailed Description
This study will investigate the effectiveness of inclusion of trans-perineal trigger point dry needling with manual therapy treatment for chronic pelvic pain with dyspareunia and associated pelvic floor dysfunctions.The use of trigger point dry needling (TrptDN) for chronic low back pain has proved beneficial.This study will evaluate the treatment outcomes of trans-perineal trigger point dry needling and manual therapy to only manual therapy for CPP. The outcomes will evaluate the number of treatment requirements between the dry needling with manual therapy group and the manual therapy group and review which group has faster resolution in pain and other associated pelvic floor symptoms.
Investigators
Shalini Wiseman
Senior Physiotherapist in Women's Health & Continence
Cork University Hospital
Eligibility Criteria
Inclusion Criteria
- •Patients reporting non-cyclical CPP with dyspareunia and associated PFD with no palpable pelvic floor pathology, but with palpable high pelvic floor muscle (PFM) tone and tenderness will be referred for physiotherapy by the gynaecology team.
- •Visceral conditions like interstitial cystitis are difficult to exclude at gynaecology review, as they mimic CPP symptoms.
- •Smokers and non-smokers included.
- •Nulliparous, singleton and multiparous patients.
Exclusion Criteria
- •Body mass index greater than 30, makes it difficult to dry needle as the required needle length is not available.
- •Chronic back pain over 6 months duration, under pain management team.
- •Orthopaedic back surgeries with implants.
- •Pelvic pathologies like endometriosis, fibroids, cysts, etc.
- •Pregnancy related pelvic pain.
- •Pregnant during the trial.
- •Pelvic organ carcinomas.
- •Undergoing cancer treatment.
- •Post gynaecology surgeries, less than 16 weeks.
- •Cardiovascular, gastroenterology, renal or orthopaedic surgery, less than 6 month's post-operative.
Outcomes
Primary Outcomes
Pain reduction or resolution within 10 treatment sessions, evaluated with the 0-10 Numeric Pain Rating Scale (0-10NPRS)
Time Frame: 10 weeks or earlier on resolution
Participants will be asked to fill the 0-10NPRS at base line, 4th, 8th and 10th session or earlier on resolution of symptoms and to review which arm has faster resolution with lesser treatment sessions.
Secondary Outcomes
- Patient treatment satisfaction in each group(10 weeks or earlier on resolution)
- Resolution in dyspareunia(10 weeks or earlier on resolution)
- Resolution in bladder, bowel and sexual dysfunction(10 weeks or earlier on resolution)