Other disorders such as irritable bowel syndrome, colitis, pelvic floor dysfunction, and neuropathy are shared between males and females. In females, common diagnoses that contribute to chronic pelvic pain include endometriosis, interstitial cystitis/painful bladder syndrome, and vulvodynia. Although the inclusion of the perineum and reproductive organs varies among the various definitions of pelvic organ anatomy, an array of related disorders affecting pelvic and/or lower abdominal organs can contribute to pain. Pain can be generally diffused throughout or quite localized within the pelvis, which is anatomically delineated as the area inferior to the umbilicus and superior to the symphysis pubis. As diagnostic nomenclature, CPPS is typically reserved for those with reported pain experienced during at least three of the previous six months, lacking in apparent pathognomonic causes, and is unrelated to reproductive or hormonal cycles. This is likely due to the nebulous presentation of symptoms and necessity of exclusion criteria required to formulate a diagnosis. Despite the global prevalence, the terminology associated with chronic pelvic pain remains inconsistent in the literature. Overall, this review consolidates the current state of evidence regarding the utilization of non-traditional interventions using CAM techniques for the management of chronic pelvic pain and recommends a future direction for the field.Ĭhronic pelvic pain syndrome (CPPS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are conditions acknowledged worldwide, affecting up to 16% of females and 10% of males, respectively. Robustness of the included clinical studies is discussed throughout the review, and attention is paid to delineating inclusion criteria of formally diagnosed CPPS compared to general pelvic or abdominal pain. The discussion suggests that reported improvements in pelvic pain or related symptomatology may be attributed to changes in the peripheral inflammasome and somatic origins of peripheral sensitization.
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This review aimed to summarize the current evidence and proposed mechanisms for non-pharmacological treatment specific to CAM and management of chronic pelvic pain centered on neuromusculoskeletal focused intervention such as acupuncture, auriculotherapy, manipulation, manual therapy, myofascial release, and phototherapy. Familiarizing physicians and the public with the newest evidence for complementary and alternative medicine (CAM) and other conservative care treatments will assist with the promotion of evidence-based practices in a safe and reliable manner. Given that conservative care such as exercise, counseling, and musculoskeletal therapy is widely recommended as first-line treatment for CPPS, an updated review of these and related methodologies are needed. New interventions involving non-pharmacological approaches to pain management have been investigated across a spectrum of clinical and pre-clinical studies. The prevalence of functional pain disorders demonstrates the importance of adequate management of ongoing symptomatology, but due to the uncertain etiology and myriad patient presentation phenotypes, reliable treatment options are difficult to implement. Chronic pelvic pain syndrome (CPPS) is a functional pain disorder characterized by ongoing pain in the apparent absence of clinically identifiable causes.
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