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27 active trials for Pelvic Pain

Randomized Controlled Trial of Vaginal Cryotherapy for Pelvic Floor Myofascial Pain

This is a placebo-controlled, randomized controlled trial to investigate the role of vaginal cryotherapy on pelvic floor myofascial pain in women. This study involves randomizing patients who are found to have pelvic floor myofascial pain on examination into one of two treatment groups: transvaginal cryotherapy or transvaginal application of a room-temperature tube. Patients will be followed up at two different time points in order to assess response to treatment. Follow-up times include immediately after application (Specific Aim #1) and two weeks following use of the intervention alone (Specific Aim #2). Patients will receive verbal and written instructions on using the intravaginal tubes by the research assistant who will not be blinded to treatment allocation. Patients will not be blinded to their treatment assignment but will not be given information on the alternative treatment. Patients will be referred to pelvic floor PT, which is considered the standard of care for treatment of pelvic floor myofascial pain at this time. As it typically takes 2-3 weeks to get in to see one of the pelvic floor PT providers at Wash U, follow up for this study will be completed prior to their attendance at pelvic floor PT. Patients will complete validated questionnaires assessing their pain, other pelvic floor symptoms, and acceptance of the intervention as a treatment option at the follow up time points.

Start: March 2019
The Effect of an Individualized Impairment-based, Orthopedic Physical Therapy Intervention (IOI), on Muscle Stiffness, Pelvic Floor Function, and Pain in Women With Chronic Pelvic Pain

The primary purpose of this study is to establish if an individualized, impairment-based orthopedic intervention (IOI) can improve pelvic floor function and pain in women with Chronic Pelvic Pain (CPP). Dry needling will be used as a part of the IOI to intervene upon peripheral muscles stiffness previously found to be more stiff in this population compared to healthy controls. This study is intended to initiate a line of research aimed at assessing widely used orthopedic physical therapy practices to address orthopedic impairments and muscle stiffness differences in women with CPP potentially decreasing time to care for a widely experienced condition. This study will guide potential future studies aimed at intervening upon a larger population and establishing the characteristics of participants who respond favorable to orthopedic care alone. First, this study will establish if this type of intervention has an effect on pelvic floor function and symptoms, pain, and muscle stiffness, all of which are often priorities of treatment for PHPTs treating CPP. A single-subject design is well suited in studying an intervention on such a heterogeneous patient population that does not currently have physical therapy treatment subclassifications. Future studies could help to establish possible subclassifications of CPP to include an orthopedic or peripheral muscle stiffness classification and empower therapists with associations between peripheral orthopedic and myofascial dysfunction and pelvic floor function and pain. This line of research could help prioritize which patients require specialty care, who could initiate care with an orthopedic PT, and who may resolve dysfunction and pain with orthopedic PT alone.

Start: April 2021
Sacro-iliac Joint Arthrodesis or Non-operative Care for Treatment of Chronic Pelvic Pain. A Randomized Study.

Background: Pelvic pain is common during pregnancy and usually subsides after delivery. Some women, however, experience severe and long-standing pelvic pain, judged to emanate from the Sacro-iliac joints (SI-joints). Radiological correlates are absent and there are diverging opinions regarding the value of different clinical testing procedures and the use of anaesthetic blocks to reveal SI-joint origin of the pain. In case of slight or moderate pain the situation may be solved by the use of analgetics and physical therapy, but in case of severe pain the situation might end up in a discussion whether surgery with arthrodesis of the SI joint might be of value. To our knowledge, however, the results from surgical treatment has not been compared with non-surgical treatment in a randomized study. Aim: The investigators´ hypothesis is that there exists a specific identifiable subgroup of patients within the chronic low back pain (CLBP) group in whom the pain emanates from the sacro-iliac (SI) joints, and that patients in this subgroup may be selected based on thorough symptom analysis, and that arthrodesis of the actual joint/s may reduce the pelvic pain. Methods: A RCT with parallel group design with pre- and post-treatment data. Inclusion of women 18-55 years old with pronounced pelvic pain for at least 2 years and having tried ordinary physical therapy without improvement and being on sick leave at least 50 percent. Operation by posterior approach with bone transplantation between the iliac bone and the sacrum, using microsurgical technique. Patients in both groups, the surgical (S) and non-surgical (NS) were all treated by formal physiotherapy at a five days stay at the Clinic and instructed to continue their training at home according to the lines given at the Clinic. Outcome: The primary outcome was perceived pelvic pain according to the assessments on the validated Balanced Inventory for Spinal Disorders questionnaire (BIS) and on a Visual Analogue Scale (VAS) before treatment and at follow-up one year after treatment. The perceived change in pain was also assessed on a transitional scale in the follow-up version of the BIS. Secondary patient reported outcome measures (PROM) were pain related functions assessed on the Oswestry Disability Index questionnaire (ODI), the BIS and the Roland-Morris questionnaire. Health related quality of life was assessed by using the Short-Form 36 (SF-36) and Euro-Quol (EQ-5D) questionnaires.

Start: October 2008