title: Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men.
abstract: 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.
authors.affiliation: Department of Urology, Stanford University School of Medicine, Stanford, California, USA. rua@stanford.edu
authors.forename: Rodney U
authors.initials: RU
authors.lastname: Anderson
authors.forename: David
authors.initials: D
authors.lastname: Wise
authors.forename: Timothy
authors.initials: T
authors.lastname: Sawyer
authors.forename: Christine
authors.initials: C
authors.lastname: Chan
mesh_terms: 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