Investigation of Acute Effects of Myofascial Trigger Point Release in Women With Chronic Pelvic Pain
Condition: Pelvic Pain; Pelvic Floor; Relaxation; Myofascial Trigger Point Pain
MeSH terms: Myofascial Pain Syndromes; Pelvic Pain
Study type: Interventional

Summary: 
      The patients diagnosed with pelvic pain will be included in the study. Orthopedic tests for
      pelvic pain were performed after routine gynecological examinations. After perineometer
      measurement, pelvic floor muscle sensitivity grading, ultrasound, and pain score evaluation,
      participants will be randomized and divided into 3 groups. According to a randomization plan
      the first group will be instructed by a physiotherapist to receive an internal myofascial
      trigger point release technique, the second group receive an external myofascial trigger
      point release technique, and the third group receive a video of relaxation exercises related
      to pelvic pain. After the application, measurement of perineometer and pelvic floor muscle
      sensitivity grading, ultrasound, and pain evaluations will be repeated.
    

Detailed description: 
      Turkey has been affected country from a busy and stressful lifestyle in our changing world
      and that leads to pelvic floor dysfunction has increased rapidly in Turkey. Pelvic pain that
      has in 1 out of every 7 women causes overactivity of pelvic floor muscles with increasing
      stress factors. In addition, it becomes chronic due to both the diagnosis process and the
      time-out of the right treatment and deteriorates the quality of life of women. There is no
      special pelvic floor physiotherapy for the management of pelvic pain in our country, which
      also causes psychosocial problems. On the other hand, myofascial trigger point release
      technique, which is proposed in addition to medical treatment alone or in pelvic floor
      physiotherapy, has been one of the current research areas in the world. However, there is no
      study in the national and international literature comparing internal and external myofascial
      trigger point relaxation techniques and also evaluating transperineal ultrasound. This study
      is unique in terms of comparing two different applications (internal and external trigger
      point relaxation technique) with ultrasound measurements in the literature.

      33 women diagnosed with pelvic pain between the ages of 18-55 will be included in this study.
      Orthopedic tests for pelvic pain will be performed after routine gynecological examinations.
      After perineometer measurement, pelvic floor muscle sensitivity grading, ultrasound and pain
      score evaluation, participants will be randomized and divided into 3 groups. The first group
      will receive internal myofascial trigger point release technique, the second group will
      receive external myofascial trigger point release technique, and the third group will be
      shown a video of relaxation exercises related to pelvic pain. After the application,
      measurement of perineometer and pelvic floor muscle sensitivity grading, ultrasound and pain
      evaluations will be repeated.
    

Intervention name(s): Internal myofascial release; External myofascial release; Control Group
Intervention type(s): Other; Other; Other
Intervention description(s): Internal myofascial trigger point release therapy consist of 30 minutes massage directly to the pelvic floor musculature by vaginally. Patients were instructed in internal myofascial relase techniques. Experienced pelvic health physiotherapist (A.B.) to use her fingers with a lubricated glove when the finger could easily reach internal trigger points and follows these steps: (a) finding internal and external trigger points associated with pelvic muscles, especially around sensitive areas of the vagina, anus, and/or pelvic floor; (b) releasing with the fingers the trigger point associated pelvic muscle tension by carefully pressing on the trigger point; Eksternal myofascial trigger point release therapy consist 30 minutes massage to the abdominal wall, gluteal area and adductors and hamstring muscles. Pain in trigger points may exist at both locations of muscle insertion as well as in the belly and lower extremity of the muscle.; The Control group will have a paper about exercises recommended in pelvic pain for 30 minutes. A physiotherapist will teach and show the exercises for pelvic pain. The home exercise for pelvic pain contains diaphragm breating, pelvic floor muscle stretching and releasing.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Basic Science
Keywords: pelvic pain; myofascial trigger point release; transperineal ultrasound