title: Pain thresholds in women with chronic pelvic pain.
abstract: OBJECTIVE
  To update on the latest developments in sensory changes of female patients with chronic pelvic pain (CPP). CPP is very common, but its pathophysiology is still controversial. Evaluation of pain sensitivity in painful and nonpainful areas is key to understanding the underlying peripheral vs. central contributions to the symptom. This in turn is fundamental to improving the treatment strategies.
  
  
  RESULTS
  We reviewed the experimental studies published over the last year on pain thresholds to different stimuli measured at both the somatic and visceral level in women with different forms of recurrent or CPP. The majority of the studies indicate a pain threshold decrease to most stimuli in skin, subcutis and muscle in painful pelvic areas, the site of referred pain from pelvic viscera, as well as a decreased pain threshold in most viscera (colon and urinary bladder). A significant threshold decrease is also found in deep somatic tissues (subcutis and muscle) outside the painful zone in the most severe cases, indicating a state of central sensitization.
  
  
  CONCLUSIONS
  These findings have important implications for clinical practice: pain threshold measurement in both painful and nonpainful sites could have important predictive value of the clinical evolution and response to therapy of CPP.
authors.affiliation: aDepartment of Medicine and Science of Aging, Ce.S.I. 'G. D'Annunzio' University Foundation, University of Chieti bInstitute of Surgical Pathology, University of Chieti, Chieti, Italy.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Giamberardino
authors.forename: Claudio
authors.initials: C
authors.lastname: Tana
authors.forename: Raffaele
authors.initials: R
authors.lastname: Costantini
mesh_terms: D059350:Chronic Pain / Q000209:etiology* / Q000503:physiopathology*; D018856:Cystitis, Interstitial / Q000150:complications; D004715:Endometriosis / Q000150:complications; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications; D009140:Musculoskeletal Diseases / Q000150:complications; D010147:Pain Measurement; D017288:Pain Threshold; D017699:Pelvic Pain / Q000209:etiology* / Q000503:physiopathology*; D059265:Visceral Pain / Q000209:etiology / Q000503:physiopathology; D056650:Vulvodynia / Q000150:complications