Pelvic floor muscle examination in female chronic pelvic pain

OBJECTIVE: To determine if women with self-reported chronic pelvic pain (CPP) were more likely to have positive findings on two vaginal pelvic floor muscle (PFM) tests compared to women without CPP when the examiner was blinded to pain status. STUDY DESIGN: This was a prospective, cross-sectional study. Blinded examiners performed two vaginal pelvic floor tests (tenderness and strength) on 48 participants: 19 with self-reported CPP and 29 who were pain-free. Relative frequency of positive findings between groups and the total number of positive physical examination findings were calculated. RESULTS: Women with self-reported CPP were more likely to have PFM tenderness (63.2% with physician [M.D.] examiners [board certified in physical medicine and rehabilitation] and 73.7% with physical therapist [P.T.] examiners) as compared to pain-free participants (Fisher's exact test [FET]), 48 p < 0.001 with M.D., p < 0.001 with P.T.). PFM weakness was not more likely in women with CPP (31.6% with M.D., 42.1% with P.T.) as compared with pain-free participants (48.3% with M.D., 17.2% with P.T.) (FET, 48 p = 0.37 with M.D., p = 0.096 with P.T.). CONCLUSION: PFM tenderness is found more frequently in women with self-reported CPP than in pain-free women. PFM strength did not differentiate CPP from pain-free participants. Improved standardization of the PFM examination across disciplines may be helpful in distinguishing subgroups and treating women with CPP.