Abstract
Background: Chronic pelvic pain (CPP) is a debilitating condition often associated with lumbopelvic or hip dysfunction because of the involvement of the deep hip rotators. Dry needling (DN) has been shown to reduce pain and improve function in other chronic, musculoskeletal conditions but as we are aware, its use in those with CPP has not been described.
Study Design: Case series.
Case Description: Two women, 72 and 62 years of age, were referred to physical therapy with CPP. The patients reported substantial functional limitations secondary to pelvic pain and previous treatments had been unsuccessful. In both patients, familiar pain was elicited with palpation of pelvic floor muscles, particularly obturator internus. Dry needling treatment to obturator internus was a primary focus of treatment in both women with secondary DN to their pelvic floor and gluteal muscles in addition to traditional physical therapy interventions.
Outcomes: Patient A demonstrated resolution of symptoms, increased range of motion, and improved mobility after 7 treatments. Her Hip Outcome Score improved from 45.31 to 97.06. Patient B reported resolution of her pelvic pain by the fifth treatment. Her Modified Oswestry Disability Index improved from 46% to 2% and her Pelvic Floor Disability Index score improved by 62.5 points.
Discussion: Both patients demonstrated substantial improvement following physical therapy with focused DN to the obturator internus, pelvic floor, and gluteal muscles. These outcomes suggest that physical therapy management using DN may prove to be a powerful treatment technique for patients with CPP. Further evaluation of DN in treating pelvic pain is warranted.