1 | INTRODUCTION
Chronic Pelvic Pain (CPP) is characterized by noncyclical pain in the pelvis or abdomen present for 3–6 months, interfering with daily function.1 CPP is also known as Urological Chronic Pelvic Pain (UCPPS) and Chronic Pelvic Pain Syndrome (CPPS),2 for the purposes of this study, CPP will be the consistent nomenclature. Rather than being perceived as a single disorder, CPP should be viewed as a pattern of symptoms caused by overlapping conditions including, Interstitial Cystitis (IC)/Bladder
Pain Syndrome (BPS), Endometriosis, Irritable Bowel Syndrome (IBS), and Pelvic Myofascial Pain.3 This prevalence between CPP and disorders of the urological organs, reproductive tract, gastrointestinal system, and musculoskeletal system explains the uncertainty in CPP’s etiology.4 The best treatment option for this minimally understood pain complex is uncertain.2 Current pharmacological treatments in CPP include antibiotics that ameliorate infection and voiding complications. Anti‐inflammatories and alpha‐ blockers can also be utilized.
Neurologic treatments include the use of neuropathic pain drugs for instance pregabalin, gabapentin, and amitriptyline. Acupuncture, lifestyle changes, physical therapy, shockwave therapy, prostatic massage, and trigger point release are nonpharmacological treatments.2 Pelvic floor physical therapy comprises of biofeedback, nerve gliding, internal myofascial release, manual therapy, muscle control exercises, muscle energy, acupressure, and mobilization techniques. Consequently, treatment of CPP may consist of two approaches: to treat chronic pain as a diagnosis and to treat the disorders that might be a cause/contributor to CPP. These approaches are not mutually exclusive and effective therapy is achieved by using both methods.3 We aim to treat the underlying myofascial pain syndrome and neurogenic pain seen in CPP patients with our outpatient neuromuscular protocol. The effectiveness of our protocol has been studied for men and women with CPP.5,6 The current study was performed to provide additional data for the efficacy of our protocol with a much greater sample size.
