Musculoskeletal Causes of Chronic Pelvic Pain: A Systematic Review of Existing Therapies: Part II*

Abstract

Chronic pelvic pain is a common clinical problem with many causes. In addition to gynecologic causes, it is important to evaluate other potential etiologies, including the pelvic musculoskeletal system. There have been few published studies on musculoskeletal causes of pelvic pain and its treatment. The objective of this study was to evaluate treatment of pelvic musculoskeletal pain among women with chronic pelvic pain. We used a set of key words pertaining to pain and the pelvic musculoskeletal structures to initially review the PUBMED database. Additional articles were sought by discussion with a clinician specializing in this field and review of relevant textbook bibliographies. Study inclusion was restricted to English-language publications that reported a patient-related chronic pelvic pain outcome measure. Each report must have described at least four patients. For each selected article, two investigators separately summarized pertinent data on study characteristics, patient profiles, intervention characteristics, and treatment outcomes. Discrepancies were resolved by discussion. Twenty-nine treatment studies met entry criteria. The existing literature largely consists of retrospective, uncontrolled observational studies. The two studies that feature control groups lack sufficient size and scope to allow generalizability. Properly designed and executed randomized, controlled trials are urgently needed to determine the true effectiveness of treatments for pelvic musculoskeletal pain. Obstetricians & Gynecologists, Family Physicians After completion of this article, the reader should be able to summarize the current data on musculoskeletal causes of chronic pelvic pain, to outline the various techniques used to treat musculoskeletal causes of chronic pelvic pain, and to recall the lack of evidence based data on the subject and need for randomized controlled trials.