title: The result of treatment on vestibular and general pain thresholds in women with provoked vestibulodynia.
abstract: OBJECTIVE
  To correlate changes in vestibular pain thresholds to general pain thresholds in a subgroup of women with provoked vestibulodynia taking part in a treatment study.
  
  
  METHODS
  Thirty-five women with provoked vestibulodynia were randomized to 4 months' treatment with either electromyographic biofeedback (n=17) or topical lidocaine (n=18). Vestibular and general pressure pain thresholds (PPTs) were measured and the health survey Short Form-36 (SF-36) was filled out before treatment and at a 6-month follow-up. Subjective treatment outcome and bodily pain were analyzed. Thirty healthy women of the same age served as controls for general PPTs and SF-36.
  
  
  RESULTS
  No differences in outcome measures were observed between the 2 treatments. Vestibular pain thresholds increased from median 30 g before to 70 g after treatment in the anterior vestibule (P<0.001) and from median 20 to 30 g in the posterior vestibule (P<0.001). PPTs on the leg and arm were lower in the patients as compared with controls both before and at the 6-month follow-up. Patients reporting total cure were 3/35; 25/35 were improved. The number of patients who frequently reported of other bodily pain was reduced after the treatment. The patients had lower scores for SF-36 (General Health, Vitality) before treatment, which was restored at the 6-month follow-up.
  
  
  CONCLUSIONS
  Treating provoked vestibulodynia by either topical lidocaine or electromyographic biofeedback increased vestibular pain thresholds, reduced dyspareunia, and improved bodily pain. The patients showed a general hypersensitivity to pressure pain compared with controls and in this study the hypersensitivity did not seem to be affected by treating the superficial dyspareunia.
authors: Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. nina.bohm-starke@ds.se
authors: Nina
authors: N
authors: Bohm-Starke
authors: Gunilla
authors: G
authors: Brodda-Jansen
authors: Jürgen
authors: J
authors: Linder
authors: Ingela
authors: I
authors: Danielsson
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis* / Q000628:therapy*; D010146:Pain / Q000175:diagnosis*; D059408:Pain Management; D010147:Pain Measurement; D017288:Pain Threshold; D013577:Syndrome; D016896:Treatment Outcome; D014847:Vulvitis / Q000175:diagnosis* / Q000628:therapy*