General Gynecology Pelvic Pain
RRM Academy Synopsis
Laser at acupoints plus drugs eased pelvic pain more than drugs alone
In a randomized trial of 36 women with long-term pelvic pain after pelvic infection, adding laser at acupuncture points lowered pain more than anti-inflammatory drugs alone. After 6 weeks, the laser group also had better quality of life and higher pressure pain thresholds.
Key Findings
- On the visual analog scale for pain, the laser group fell from 7.66 to 3.94 and the control group from 7.33 to 4.94. Percent change was 48.56% against 32.61%.
- After treatment, the laser group scored lower on pain than the control group, with a mean difference of −1.00 (95% CI −1.57 to −0.43, p = 0.001).
- On the SF-12 quality-of-life survey, the laser group rose from 71.16 to 85.72 and the control group from 68.72 to 76.61. The between-group difference was 9.11 (95% CI 4.64 to 13.58).
- Pressure pain thresholds were significantly higher in the laser group at 12 points (p = 0.001 to 0.01). At the right iliac point the difference was 2.6 (95% CI 1.88 to 3.31).
- The paper reports no adverse effects or complications in either group during the study.
Interpretation
The study is a double-blinded randomized controlled trial at Cairo University Hospital of 36 married women, aged 25 to 40, with chronic pelvic pain after treated pelvic inflammatory disease. Both groups of 18 took anti-inflammatory drugs for six weeks, and only the study group received laser. Women with endometriosis, adenomyosis or other pelvic pain causes were excluded. The authors call for larger studies with longer follow-up.
RRM Context
Restorative reproductive medicine looks for the cause of chronic pelvic pain. The trial enrolled women whose pain followed treated pelvic inflammatory disease. It excluded endometriosis, adenomyosis and pelvic congestion. The findings add trial evidence on laser as a non-drug addition for pain in that group.
Abstract
Background and Objectives
Chronic pelvic pain (CPP) is a common complication of pelvic inflammatory disease (PID). Although acupuncture has been increasingly used for the management of CPP, there is insufficient research to support the use of laser stimulation of sensitized acupoints. This study aimed to investigate the effects of laser on sensitized acupoints on pelvic pain perception and quality of life in women with pelvic inflammatory disease.
Materials and Methods
Thirty-six women with CPP caused by chronic pelvic inflammatory disease were randomly divided into two equal groups. Both groups received non-steroidal anti-inflammatory drugs, while the study group also received a low-level laser at sensitized acupoints for 6 weeks. All the patients were evaluated before and after the intervention. The 12-item Short-Form Health Survey (SF-12) was used to measure the quality of life, while a pressure algometer and visual analog scale for pain (VAS-P) were used to measure pain sensitivity and intensity, respectively. A mixed MANOVA was used to investigate the effects of the treatment.
Results
A mixed MANOVA on VAS, SF-12, and PPT scores revealed significant interaction effects of treatment and time (F = 38.34, p = 0.001, partial η2 = 0.96) and main effects of treatment (F = 9.74, p = 0.001) and time (F = 110.1, p = 0.001). Post-treatment, the study group showed greater reductions in VAS (MD = -1.00, p = 0.001), improvements in SF-12 (MD = 9.11, p = 0.001), and increased Pressure Pain Thresholds (PPT) at multiple anatomical points (p = 0.001-0.01).
Conclusions
Laser biostimulation of neurogenic-sensitized acupoints significantly improves pain perception, intensity, and quality of life in women with CPP. suggested that the utilization of laser therapy at sensitized acupoints should be considered a potential component of a rehabilitation program for females suffering from chronic pelvic pain resulting from pelvic inflammatory disease. (Clinicaltrials.gov identifier: NCT05537207; Date of registration: 13 September 2022).
