Lidocaine Injections Help Women with Chronic Pelvic Pain

Lidocaine Injections Help Women with Chronic Pelvic Pain

By Staff

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.

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Authored by: Staff

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Donna Skelton

Thank you for the information. I am NOT of childbearing age, but suffer from IBS, interstitial cystitis and painful areas on my abdomen when touched. This gIves me hope that I can possibly be helped at some point.

As one with chronic myofascial pain (CMP/MPS), I know it contributes to my chronic pelvic pain (CPP), interstitial cystitis/painful bladder syndrome, and vulvodynia. I also have a Tarlov’s cyst sitting at S3 nerve root that causes excruciating nerve pain down my leg. S3 is a very unusual place to have an epidural, but thanks to a terrific pain doctor and diagnostician, he has been able to locate and successfully calm the inflammation. In my case, that S3 epidural inadvertently helped my CPP and IC. We are not all exactly the same anatomically, but in my case, this particular nerve root bifurcates to my bladder. I also have piriformis syndrome on both sides and suffer from post herpatic neuralgia that affected my pudendal and sciatic nerve on the left. I am sharing this so readers have the entire clinical picture and can understand why it is so important that treatments be individualized.

A handful of urogynecologists across the US are performing trigger point injections (TPIs) directly into the pelvic floor muscles via the vagina with reported success. I would like to see a more aggressive study using both techniques.

CPP from any source greatly interferes with quality of life and with relationships. In women, it causes extreme pain with intercourse and in men TrPs cause difficulty with urination, CPP, and impotence The lack of intimacy can be devastating to a relationship, but because of the sensitivity of the topic, it is seldom discussed.

And folks with CPP are no strangers to being labeled with psychosomatic disorder either, simply because those who would do so are ignorant regarding the role the myofascia plays in the chronic pain.

I want to thank you Ed for opening providing a platform that opens the discussion on this most important issue.