Physical therapy evaluation of patients with chronic pelvic pain: a controlled study

OBJECTIVE: The purpose of this study was to determine the relative frequency of positive musculoskeletal exam findings between patients with chronic pelvic pain (CPP) and healthy control subjects. STUDY DESIGN: We conducted a masked, prospective, cross-sectional study of abnormal pelvic, abdominal, and back examination findings in 19 women with CPP vs 20 healthy control subjects. RESULTS: Women with CPP had more frequent abnormal musculoskeletal findings than did control subjects asymmetric iliac crests (61% vs 25%), pubic symphysis heights (50% vs 10%), and positive posterior pelvic provocation testing (37% vs 5%; all P < .05). Patients with pain exhibited more tenderness at several abdominal muscle sites, had higher median total pelvic floor tenderness scores (3/24 vs 0/24; P < .05), and less control of the pelvic floor ( unable to maintain 10 seconds of relaxation, 78% vs 20%; P < .001). CONCLUSION: The higher frequency of positive pelvic musculoskeletal findings in CPP suggests that an investigation of somatic pain generators is warranted in these patients.