title: Tender point examination in women with vulvar vestibulitis syndrome.
abstract: OBJECTIVE
  To examine whether generalized pain sensitivity in women with vulvar vestibulitis syndrome (VVS) is increased, suggestive of altered pain processing at the level of the central nervous system, and to investigate pain history and other pain measures in women with VVS.
  
  
  METHODS
  Sixteen women with VVS and 16 age-matched (+/-3 years) and oral contraceptive status-matched (yes or no) control women participated in this cross-sectional study. The TP examination, typically used in the diagnosis of FMS, consists of the palpation of 9 bilateral nonvulvar areas by a blinded rheumatologist and was the main measure of generalized sensitivity. Pain intensity and unpleasantness rating (0 to 10) were recorded after each palpation. In addition, nonvulvar pain history, pain interference, catastrophizing, and anxiety were assessed via questionnaires.
  
  
  RESULTS
  Women with VVS had significantly more painful TPs than nonaffected women; they reported significantly higher pain intensity and unpleasantness ratings and displayed more pain behaviors than controls (P<0.05). Furthermore, VVS patients reported having experienced more pain problems and associated interference, they catastrophized more in response to vulvar and nonvulvar pain, and they had higher levels of trait anxiety than controls (P<0.05).
  
  
  CONCLUSIONS
  These results are consistent with recent findings of generalized sensitivity and heightened responses to pain in women with VVS. These results suggest that the mechanisms involved in VVS may include those that are genital specific in addition to those that are more generalized, and possibly centrally mediated.
authors.affiliation: Department of Psychology, Queen's University, Kingston, Ontario, Canada. pukallc@post.queensu.ca
authors.forename: Caroline F
authors.initials: CF
authors.lastname: Pukall
authors.forename: Murray
authors.initials: M
authors.lastname: Baron
authors.forename: Rhonda
authors.initials: R
authors.lastname: Amsel
authors.forename: Samir
authors.initials: S
authors.lastname: Khalifé
authors.forename: Yitzchak M
authors.initials: YM
authors.lastname: Binik
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006941:Hyperesthesia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold; D010173:Palpation / Q000379:methods*; D017699:Pelvic Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013577:Syndrome; D014845:Vulvar Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology