title: Importance of pelvic muscle tenderness evaluation in women with chronic pelvic pain.
abstract: OBJECTIVE
  To determine the prevalence of pelvic muscle tenderness in women with chronic pelvic pain (CPP) and to assess the importance of evaluating muscle tenderness in such women.
  
  
  METHODS
  Observational study of 48 healthy female volunteers and 108 women with CPP, who were clinically evaluated for pelvic muscle tenderness by two researchers blinded to all clinical data.
  
  
  RESULTS
  The frequency of clinically detected pelvic muscle tenderness was significantly higher in women with CPP than in healthy volunteers (58.3% vs 4.2%, P < 0.001). Among women with CPP, those with pelvic muscle tenderness had higher Beck Depression Index scores (22 [6-42] vs 13 [3-39], P = 0.02) and higher rates of dyspareunia (63.5% [40/63] vs 28.9% [13/45], P < 0.004) and constipation (46.0% [29/63] vs 26.7% [12/45], P = 0.05) than those without pelvic muscle tenderness.
  
  
  CONCLUSIONS
  Tenderness of pelvic muscles was highly prevalent among women with CPP and was associated with higher BDI scores and higher rates of dyspareunia and constipation. Determination of pelvic muscle tenderness may help in identifying women who require more intense treatment for CPP.
authors.affiliation: Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. montenegro_ml@hotmail.com
authors.forename: Mary Lourdes Lima de Souza
authors.initials: ML
authors.lastname: Montenegro
authors.forename: Elaine Cristine Lemes
authors.initials: EC
authors.lastname: Mateus-Vasconcelos
authors.forename: Júlio César
authors.initials: JC
authors.lastname: Rosa e Silva
authors.forename: Antonio Alberto
authors.initials: AA
authors.lastname: Nogueira
authors.forename: Francisco José Candido
authors.initials: FJ
authors.lastname: Dos Reis
authors.forename: Omero Benedicto
authors.initials: OB
authors.lastname: Poli Neto
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003248:Constipation / Q000150:complications / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004414:Dyspareunia / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D018482:Muscle, Skeletal / Q000473:pathology*; D010147:Pain Measurement; D017773:Pelvic Floor / Q000502:physiology; D017699:Pelvic Pain / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D010808:Physical Examination