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Monday, October 14, 2013

Trailers (62): Pain sensitivity in women with chronic pelvic pain

As-Sanie, et al. Increased pressure pain sensitivity in women with chronic pelvic pain

Why should you read about this topic?

Understanding how women with chronic pelvic pain differ from women who are pain-free may illuminate effective treatment pathways and rewarding research endeavors.

What were the authors trying to do?

To determine whether women with chronic pelvic pain have altered pain sensitivity in comparison with women who are pain-free and, if so, whether differences are related to comorbid pain syndromes or endometriosis.

Who participated and in what setting?

Women (N=144) 18-52 years of age with chronic pelvic pain or dysmenorrhea with or without endometriosis or pain-free with or without (healthy controls) endometriosis between 2006-10 at the University of Michigan

What was the study design?

Cross-sectional, observational

What were the main outcome measures?

Pain thresholds with thumbnail pressure

What were the results?

Pain thresholds were lower in women with pelvic pain compared with healthy controls.  The presence and severity of endometriosis or number of comorbid pain syndromes were not associated with a difference in pain thresholds.

What is the most interesting image in the paper?

Table 3

What were the study strengths and weaknesses?

Strengths:  validated sensory testing method; systematic screening for comorbid pain syndromes; well-characterized pain experiences.   Weaknesses: healthy controls not surgically evaluated for endometriosis; subgroup analysis constrained by small sample size.

What does the study contribute for your practice?

Women with chronic pelvic pain have lower pain thresholds even for nonpelvic painful stimuli, perhaps related to central amplification of pain processing.