Background: Chronic pelvic pain (CPP) is defined as recurrent or continuous pain in the lower
abdomen or pelvis, non-menstrual or non-cyclic, lasting at least 6 months. There is strong evidence
that up to 85% of patients with CPP have serious dysfunction of the musculoskeletal system,
including abdominal myofascial syndrome (AMPS). AMPS is characterized as deep abdominal pain,
originating from hyperirritable trigger points, usually located within a musculoskeletal range or its
fascia of coating. In the literature, there are few studies that address AMPS.
Objective: This study aimed to compare the responses of ashi acupuncture treatment and local
anesthetic injection in the treatment of chronic pelvic pain secondary to abdominal myofascial pain
syndrome in women.
Study Design: Randomized controlled clinical trial.
Setting: Tertiary University Hospital.
Methods: Women with a clinical diagnosis of CPP secondary to AMPS were randomized and
evaluated using instruments to assess clinical pain, namely, the visual analogue scale (VAS),
numerical categorial scale (NCS), and the McGill Questionnaire, after receiving treatment with
ashi acupuncture (group A, n = 16) or local anesthetic injections (group B, n = 19). They were
reevaluated after one week and one, 3, and 6 months after each treatment, in addition to
assessments of pain and adverse events performed during the sessions.
Results: Ashi acupuncture and local anesthetic injections were both effective in reducing clinical
pain assessed through the analyzed variables among study participants. There was no difference
between the groups and there was a strong correlation between these pain assessment instruments.
Limitations: The absence of blinding to the different forms of treatment among the patients
and the researcher directly involved in the treatment, the absence of a placebo group, the selective
exclusion of women with comorbidities and other causes of CPP, and the difference between the
number of sessions used for each technique.
Conclusion: Treatments with ashi acupuncture and local anesthetic injections were effective in
reducing clinical pain in women with abdominal myofascial pain syndrome.
Key words: Chronic pelvic pain, abdominal myofascial pain syndrome, trigger points,
acupuncture, topical injectable anesthetic
Anaesthetic injection versus ischemic compression for the pain relief of abdominal wall trigger points in women with chronic pelvic pain
