Format

Send to

Choose Destination
See comment in PubMed Commons below
Obstet Gynecol. 2013 Nov;122(5):1047-55. doi: 10.1097/AOG.0b013e3182a7e1f5.

Increased pressure pain sensitivity in women with chronic pelvic pain.

Author information

1
Departments of Obstetrics and Gynecology, Anesthesiology, and Internal Medicine (Rheumatology), University of Michigan Health Center, Ann Arbor, Michigan; and the Department of Obstetrics and Gynecology, Northshore University Health System, Chicago, Illinois.

Abstract

OBJECTIVE:

To determine whether women with chronic pelvic pain and variable degrees of endometriosis demonstrate altered pain sensitivity relative to pain-free healthy women in a control group and whether such differences are related to the presence or severity of endometriosis or comorbid pain syndromes.

METHODS:

Four patient subgroups (endometriosis with chronic pelvic pain [n=42], endometriosis with dysmenorrhea [n=15], pain-free endometriosis [n=35], and chronic pelvic pain without endometriosis [n=22]) were each compared with 30 healthy women in a control group in this cross-sectional study. All patients completed validated questionnaires regarding pain symptoms and underwent screening for comorbid pain disorders. Pain sensitivity was assessed by applying discrete pressure stimuli to the thumbnail using a previously validated protocol.

RESULTS:

While adjusting for age and education, pain thresholds were lower in all subgroups of women with pelvic pain relative to healthy women in the control group (all P values <.01). There was no difference in pain thresholds when comparing patients with endometriosis without pelvic pain with healthy women in the control group (mean difference 0.02 kg/m2, 95% confidence interval -0.43 to 0.47). The presence and severity of endometriosis and number of comorbid pain syndromes were not associated with a difference in pain thresholds.

CONCLUSION:

Women with chronic pelvic pain demonstrate increased pain sensitivity at a nonpelvic site compared with healthy women in a control group, which is independent of the presence or severity of endometriosis or comorbid pain syndromes. These findings support the notion that central pain amplification may play a role in the development of pelvic pain and may explain why some women with pelvic pain do not respond to therapies aimed at eliminating endometriosis lesions.

LEVEL OF EVIDENCE:

II.

PMID:
24104772
PMCID:
PMC3897295
DOI:
10.1097/AOG.0b013e3182a7e1f5
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins Icon for PubMed Central
    Loading ...
    Support Center