Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men.
OBJECTIVE
A perspective on the neurobehavioral component of the etiology of chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) is emerging. We evaluated a new approach to the treatment of CP/CPPS with the Stanford developed protocol using myofascial trigger point assessment and release therapy (MFRT) in conjunction with paradoxical relaxation therapy (PRT).


METHODS
A total of 138 men with CP/CPPS refractory to traditional therapy were treated for at least 1 month with the MFRT/PRT protocol by a team comprising a urologist, physiotherapist and psychologist. Symptoms were assessed with a pelvic pain symptom survey (PPSS) and National Institutes of Health-CP Symptom Index. Patient reported perceptions of overall effects of therapy were documented on a global response assessment questionnaire.


RESULTS
Global response assessments of moderately improved or markedly improved, considered clinical successes, were reported by 72% of patients. More than half of patients treated with the MFRT/PRT protocol had a 25% or greater decrease in pain and urinary symptom scores, as assessed by the PPSS. In those at the 50% or greater improvement level median scores decreased 69% and 80% for pain and urinary symptoms, respectively. The 2 scores decreased significantly by a median of 8 points when the 25% or greater improvement was first observed, that is after a median of 5 therapy sessions. PPSS and National Institutes of Health-CP Symptom Index showed similar levels of improvement after MFRT/PRT protocol therapy.


CONCLUSIONS
This case study analysis indicates that MFRT combined with PRT represents an effective therapeutic approach for the management of CP/CPPS, providing pain and urinary symptom relief superior to that of traditional therapy.
Anderson
Rodney U
RU
Department of Urology, Stanford University School of Medicine, Stanford, California, USA. rua@stanford.edu
Wise
David
D
Sawyer
Timothy
T
Chan
Christine
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes; D017699:Pelvic Pain / Q000209:etiology / Q000628:therapy*; D011472:Prostatitis / Q000150:complications / Q000628:therapy*; D012064:Relaxation Therapy; D011795:Surveys and Questionnaires