Effect of Biomechanical Alignment and Jaw on Women With Pelvic Pain
Condition: Pelvic Pain
MeSH terms: Pelvic Pain
Study type: Observational

Summary: 
      Chronic pelvic pain (CPP), a frequent complaint in clinical gynaecology, is defined as cyclic
      or acyclic pain located in the pelvis, persisting for 6 months or more, and severe enough to
      cause functional incapacity that requires medical or surgical treatment (or both). Chronic
      pelvic pain is the reason for approximately 10% of all gynaecologic consultations
    

Detailed description: 
      Women who showed an imbalance of the pelvis also experienced greater pain. A possible
      explanation for this is that the change in the position of the uterus, due to the imbalance
      of the pelvis, prompted an excessive amount of prostaglandin to be secreted. When the spinal
      alignment of women who had intense menstrual pain was put back to normal, the pain was
      alleviated. The level of tension in the ligaments and nerves connecting the sacral vertebrae
      and the uterus is the cause off the menstrual pain. Due to the abnormal restriction of
      movement of the lumbosacral vertebrae, body fluid increase within the pelvis as wells
      contraction of the uterus leading to the intensification of the menstrual pain.

      Stabilization of anterior and lateral pelvic curves through exercise or osteopathic
      manipulative techniques that utilizes techniques of muscle energy, balanced ligamentous
      tension, myofascial release, strain and counterstrain to assist muscles to keep the spine
      upright and sufficiently flexible to support good posture . Correct posture involves a
      straight spine, which maintains the natural curve of the spine in the human body. Correct
      posture minimizes the strain on the human body by maintaining balance of the muscles and
      skeleton. This balanced musculoskeletal state protects the supporting structures in the body
      and prevents damage or progressive deformation in all positions, including standing, lying
      down, and sitting. Additionally, correct posture implies not inclining the body forward,
      backward, left, or right.

      The temporomandibular joint is surrounded by ligaments, muscles, nerves, and blood vessels.
      The masticatory muscles enable mouth opening and closing, lateral movement, and forward and
      backward movement of the mouth, and excessive tension or imbalance of muscles can limit the
      joint movements, possibly resulting in limited ROM. Thus, it can be surmised that the
      imbalance in the spinal muscles caused the imbalance in the temporomandibular muscles and
      limited TMJ mobility.
    

Intervention name(s): Study group (group A)
Intervention type(s): Diagnostic Test
Intervention description(s): Maximal vertical mouth opening (MIO):
From sitting position, with the use of the calliper, the distance between the incisal edges along the midline of the upper and lower central incisors without pain was measured, by placing one end of the poley gauge against the incisal edge of one of the upper central incisors, and the other end against the incisal edge of the opposing lower incisor.
The distance recorded in millimetres, the subjects was instructed to" open your mouth as wide as possible without causing pain or discomfort". The poley gauge was sterilized with antiseptic solution before and after each measure
Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        90 women will participate in this study, thirty women diagnosed as having cyclic pelvic
        pain and thirty women diagnosed as having non cyclic pelvic pain thirty women normal women
        will not having pelvic pain. They will be selected from outpatient clinic of obstetrics and
        Gynaecology department in El-Hosary family health Centre.

        All participants will be given a full explanation of the protocol of the study and informed
        consent form will be signed from each subject before participating in the study (