E-Posters-Trigger Point Dry Needling for Treatment of Pelvic Floor Myofascial Dysfunction

Trigger Point Dry Needling for Treatment of Pelvic Floor Myofascial Dysfunction - Claire E Spellman, MD

Pdf Summary

Trigger point dry needling (TDN) has emerged as a beneficial and cost-effective therapy for pelvic floor myofascial dysfunction, which can cause urinary incontinence, fecal incontinence, and chronic pelvic pain in women. Currently, the standard of care includes pelvic floor physical therapy (PFPT) followed by trigger point injections (TPIs) administered by a physician. However, TDN, performed by a physical therapist without medication, has shown to be just as effective as TPIs and can reduce the need for physician involvement and costly medications.<br /><br />A retrospective cohort study examined the outcomes of TDN treatment in 83 patients with pelvic floor myofascial dysfunction. The results showed that 98.8% of patients experienced subjective improvement in pain and pelvic floor function. The average improvement in self-perceived function was 3.78 points on the Patient Specific Functional Scale (PSFS), and there was an average pain reduction of 4.4 points on the Likert scale. Importantly, there were no reported negative outcomes or worsened symptoms.<br /><br />TDN was performed by a physical therapist who determined the muscles to be needled through a biomechanical examination and muscle palpation. The procedure involved inserting needles into muscle trigger points and manipulating them until the myofascial trigger point was resolved. Soft tissue mobilization and functional neuromuscular training followed TDN.<br /><br />The use of TDN as an alternative to TPIs has several potential benefits, including easier and quicker access to effective therapy, cost savings by transitioning care to physical therapists, and eliminating the need for costly medications. The American Academy of Orthopedic Manual Physical Therapists has endorsed the use of TDN as an evidence-based treatment within the scope of practice for physical therapists.<br /><br />The study does have some limitations, including the qualitative data and the fact that it was conducted at a single center with a sole physical therapist, which limits generalizability. Further studies are needed to explore the long-term effects of TDN, objective measures of improvement, and to compare outcomes with TPIs through randomized controlled trials.<br /><br />Overall, TDN has been shown to be a safe, effective, and cost-effective treatment for pelvic floor myofascial dysfunction, offering potential benefits to patients and the healthcare system.

Keywords

Trigger point dry needling

pelvic floor myofascial dysfunction

urinary incontinence

fecal incontinence

chronic pelvic pain

pelvic floor physical therapy

trigger point injections

physical therapist

Patient Specific Functional Scale

Likert scale