Top

Published in:

01-10-2011 | Invited Commentary

Understanding Multisymptom Presentations in Chronic Pelvic Pain: The Inter-relationships Between the Viscera and Myofascial Pelvic Floor Dysfunction

Author: Donna Hoffman

Published in: Current Pain and Headache Reports | Issue 5/2011

Abstract

Patients presenting with chronic pelvic pain frequently complain of multiple symptoms that appear to involve more than one organ system, creating diagnostic confusion. The multisymptom presentation of chronic pelvic pain has been frequently described. This article describes four proposed explanations for the clinical observation of multisymptom presentations of patients with chronic pelvic pain. These include the concepts of viscerovisceral convergence; viscerosomatic convergence; hypertonicity of pelvic floor muscles creating visceral symptoms along with somatovisceral convergence; and central sensitization with expansion of receptive fields.

Peters K et al. Characterization of a clinical cohort of 87 women with interstitial cystitis/painful bladder syndrome. Urology. 2008;71(4):634–40.PubMedCrossRef

Berkley KJ. A life of pelvic pain. Physiol Behav. 2005;86(3):272–80.PubMedCrossRef

Brinkert W et al. Dysmenorrhea is associated with hypersensitivity in the sigmoid colon and rectum. Pain. 2007;132(Suppl1):546–51.

Howard FM. Pelvic pain diagnosis and management. Lippincott Williams &Wilkins; 2000. p. 285.

Giamberardino MA et al. Pain threshold variations in somatic wall tissues as a function of menstrual cycle, segmental site and tissue depth in non-dysmenorrheic women, dysmenorrheic women and men. Pain. 1997;71(2):7187–97.CrossRef

Wesselmann V et al. Mechanisms of referred visceral pain: uterine inflammation in the adult virgin rat results in neurogenic plasma extravasation in the skin. Pain. 1997;73:309–12.PubMedCrossRef

Giamberardino MA, Berkley KJ. Influence of endometriosis on pain behaviors and muscle hyperalgesia induced by a urethral calculosis in female rats. Pain. 2002;95:247–57.PubMedCrossRef

Travell J, Simons D. The trigger point manual, vol. 1. Baltimore: Williams & Williams; 1983.

Fitzgerald MP, Kotarinos R. Rehabilitation of the short pelvic floor. I: Background and patient evaluation. Int Urogynecol J. 2003;14:261–8.CrossRef

10.

Weiss J. Chronic pelvic pain and myofascial trigger points. Pain Clin. 2000;2(6):13–8.

11.

Doggweiler R, Jasmin L, Schmidt RA. Neurogenically mediated cystitis in rats: an animal model. J Urol. 1998;160:1551–6.PubMedCrossRef

12.

Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009;10(9):895–926.PubMedCrossRef

Title: Understanding Multisymptom Presentations in Chronic Pelvic Pain: The Inter-relationships Between the Viscera and Myofascial Pelvic Floor Dysfunction
Author: Donna Hoffman
Publication date: 01-10-2011
Publisher: Current Science Inc.
Published in: Current Pain and Headache Reports / Issue 5/2011
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI: https://doi.org/10.1007/s11916-011-0215-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Understanding Multisymptom Presentations in Chronic Pelvic Pain: The Inter-relationships Between the Viscera and Myofascial Pelvic Floor Dysfunction

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2011

Pain Perception during Menstrual Cycle

Sex Hormones and Primary Headaches Other than Migraine

Latent Myofascial Trigger Points

Endometriosis and Headache

Sleep Disorders and Fibromyalgia

Melatonin for Migraine Prevention