• Andreia Moreira de Souza Mitidieri, Maria Carolina Dalla Vecchia Baltazar, da Silva Ana Paula Moreira APM Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo., Gurian Maria Beatriz Ferreira MBF Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo., Omero Benedicto Poli-Neto, Francisco Jose Candido-Dos-Reis, Antonio Alberto Nogueira, and Rosa-E-Silva Julio Cesar JC Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo..
• Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo.
• Pain Physician. 2020 Sep 1; 23 (5): 507-518.

BackgroundChronic 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.ObjectiveThis 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 DesignRandomized controlled clinical trial.SettingTertiary University Hospital.MethodsWomen 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.ResultsAshi 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.LimitationsThe 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.ConclusionTreatments with ashi acupuncture and local anesthetic injections were effective in reducing clinical pain in women with abdominal myofascial pain syndrome.

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