title: Chronic pelvic pain syndrome: reduction of medication use after pelvic floor physical therapy with an internal myofascial trigger point wand.
abstract: This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).
authors.affiliation: Stanford University School of Medicine, 574 Junipero Serra Blvd, Stanford, CA, 94305, USA, rua@stanford.edu.
authors.forename: Rodney U
authors.initials: RU
authors.lastname: Anderson
authors.forename: Richard H
authors.initials: RH
authors.lastname: Harvey
authors.forename: David
authors.initials: D
authors.lastname: Wise
authors.forename: J
authors.initials: J
authors.lastname: Nevin Smith
authors.forename: Brian H
authors.initials: BH
authors.lastname: Nathanson
authors.forename: Tim
authors.initials: T
authors.lastname: Sawyer
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017773:Pelvic Floor / Q000503:physiopathology*; D017699:Pelvic Pain / Q000188:drug therapy / Q000628:therapy*; D012064:Relaxation Therapy / Q000295:instrumentation / Q000379:methods*; D013577:Syndrome; D061028:Trigger Points / Q000503:physiopathology*