title: Reduction of Pain Sensitivity is Associated with the Response to Treatment in Women with Chronic Pelvic Pain.
abstract: OBJECTIVE
  The objective of this study was to evaluate whether pain thresholds to electrical stimulation of the skin change in the response to treatment in women with chronic pelvic pain (CPP).
  
  
  METHODS
  Fifty-eight women with persistent pelvic pain for at least 6 months, from a tertiary care setting, were included in this study. All women were evaluated before the therapeutic intervention and at 6 months of multidisciplinary treatment. To estimate the pain threshold, we used transcutaneous electrical nerve stimulation on the anterior surface of the nondominant arm. The intensity of clinical pain was estimated by a visual analog scale and by the McGill questionnaire.
  
  
  RESULTS
  The mean of pain threshold increased from 14.2 to 17.4 after 6 months of treatment (P < 0.0001). The effect sizes of the increase of electrical pain threshold were 0.86 (95% CI, 0.38 to 1.34) in the group with pain reduction and 0.53 (95% CI, -0.08 to 1.15) in the group without pain reduction.
  
  
  CONCLUSIONS
  The sensitivity to experimental pain was reduced after 6 months of multidisciplinary treatment for CPP. Our data provided additional evidence of central sensitization in women with CPP.
authors.affiliation: Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Maria Beatriz
authors.initials: MB
authors.lastname: Ferreira Gurian
authors.affiliation: Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Omero Benedicto
authors.initials: OB
authors.lastname: Poli Neto
authors.affiliation: Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Julio Cesar
authors.initials: JC
authors.lastname: Rosa e Silva
authors.affiliation: Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Antonio Alberto
authors.initials: AA
authors.lastname: Nogueira
authors.affiliation: Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Francisco Jose
authors.initials: FJ
authors.lastname: Candido dos Reis
mesh_terms: D000328:Adult; D059333:Central Nervous System Sensitization / Q000502:physiology; D059350:Chronic Pain / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold / Q000502:physiology*; D017699:Pelvic Pain / Q000503:physiopathology* / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome
keywords: Central Sensitization; Chronic Pelvic Pain; Electrical Pain Threshold