Transcranial Direct Current Stimulation combined with Physiotherapy in the control of Chronic Pelvic Pain: a case report

Abstract

INTRODUCTION: Chronic Pelvic Pain (CPP) is a non-menstrual pain condition of intense pain that can cause dysfunctions in some aspects such as quality of life, sexual function, among others. OBJECTIVES: To evaluate the effects of transcranial direct current stimulation (tDCS) on pain, as well as pelvic floor functionality, sexual dysfunction and quality of life in a patient with CPP. METHODS AND MATERIALS: This is a case report of patients with significant CPP who underwent tDCS for 5 consecutive days, targeting the dorsolateral prefrontal cortex (DLFPC) at 2mA for 20 minutes, in combination with physiotherapy. Pain scales, a sexual function questionnaire, pelvic floor muscle function and quality of life measures were used for evaluation. RESULTS: There was a 62.06% improvement in pain intensity and a 22.91% improvement in pain interference. The average pain score decreased from 10 at the start of the intervention (D0) to 3 in the first week (D1) and 6 in the second week (D2) of post-intervention menstruation. Regarding sexual function, the results were 31.2 at D0, 31.8 at D1 and 29.3 at D2. Improvement was observed in pelvic floor muscle strength, endurance, and repetitions at D1 and D2, although there was a decrease in strength compared to D2. The average scores for domains of quality of life were as follows: physical (55.95), psychological (59.72), social relationships (69.44) and environment (82.29). CONCLUSION: tDCS positively affected pain management and pelvic floor muscle function in the patient. However, there were no significant gains observed in other domains.