Lidocaine injections are better than ischemic compression via physical therapy in treating chronic pelvic pain (CPP) in women, according to a study published in BMC Anesthesiology.
Chronic pelvic pain originates from the abdominal wall and are associated with trigger points in approximately 30% of women who suffer in CPP.
The parallel group randomized trial included 30 women of reproductive age with chronic pelvic pain and trigger points of the inferior abdominal wall.
One group received an injection of 2 mL 0.5 % lidocaine without a vasoconstrictor into a trigger point. The other group received ischemic compression via physical therapy at the trigger points three times, with each session lasting for 60 s, and a rest period of 30 s between applications. Both treatments were administered during one weekly session for 4 weeks.
Women with comorbidities or other causes of chronic pelvic pain were omitted from the study.
The study participants were evaluated at baseline and then again after 1 week, 4 weeks and 12 weeks.
Clinical response rates and pain relief were significantly better at 1, 4, and 12 weeks for those receiving lidocaine injections than ischemic compression via physical therapy.
Women treated with lidocaine progressively improved at each evaluation stage, while women treated with ischemic compression did not show considerable changes in pain relief after their interventions.
“To our knowledge, this is the first randomized trial demonstrating the superiority of a local anesthetic for the treatment of the trigger points in the inferior abdominal wall of women with chronic pelvic pain even though this method has been proven to be effective in the treatment of other myofascial syndromes, and is similar to the effects of the lidocaine patch,” the study authors wrote.
“Since we selectively excluded subjects with comorbidities and other causes of chronic pelvic pain, we cannot confirm that this intervention, compared to those that had been applied by experts, works in the more complex ‘real-life’ setting. Thus, future pragmatic clinical trials are needed in order to confirm the effectiveness of this method in a wider variety of circumstances as well as assess whether it is better compared to techniques such as dry needling or acupuncture, for example.”
Chronic pelvic pain (CPP) is a common clinical condition among women of reproductive age. It causes a negative impact on the quality of life and significant socioeconomic repercussions.