Eficacia de la radiofrecuencia monopolar capacitiva resistiva y de las técnicas de inducción miofascial en el síndrome de dolor pélvico crónico

Zusammenfassung

Background Chronic pelvic pain syndrome (CPPS) is defined as “intermittent or constant non-cancer pain in the lower abdomen or pelvis, both in men and women, of at least 6 months duration, and with negative consequences that can be cognitive, behavioral, sexual and emotional. It has a high prevalence in both women and men, and in 61% of cases the etiology is unknown. Manual therapy is the most widely used first-line physiotherapy treatment and, among the types of techniques that exist, are myofascial induction techniques (TIM), which through specific gentle movements help to relax the tissues. The other treatment used as a novel technique is resistive capacitive monopolar radiofrequency (RFMCR), which consists of a non-invasive strategy that promotes tissue regeneration through the action of low frequency electrical currents. Despite its proven efficacy in other musculoskeletal pathologies, there is not enough scientific evidence regarding its role in the management of CPPS. Objectives To assess whether the application of resistive capacitive monopolar radiofrequency therapy (RFMCR) associated with physiotherapeutic myofascial induction (TIM) techniques together with health education provides benefits compared to physiotherapy techniques and health education alone, in the management of patients with chronic pelvic pain syndrome (CPPS). Methods To determine the effect of myofascial induction techniques alone, a quasi-experimental before-after study was performed. To determine the efficacy of adding RFMCR to myofascial induction techniques in patients with CPPS, a triple-blind randomized clinical trial was suggested and conducted. Results Fifty patients (27 women and 23 men) were included in the quasi-experimental study, with a mean age of 44.8 years (SD 12.1) and a mean duration of symptoms of 58.3 months (SD 60.5). . The per-protocol analysis showed that the intensity of pain through the visual analogic scale (VAS) resulted in 3.99 points at the end of the intervention and the quality of life through the SF-12 health questionnaire improved in the physical and mental summaries in 5.45 and 5.87 points, respectively (p<0.05). The adherence was 86.7%. In the triple-blind randomized clinical trial, 81 patients (67.9% women) with a mean age of 43.6 years (SD 12.9) were included. The RFMCR decreased by more than two points the level of pain in the visual analogue scale (VAS) in the intervention group (p<0.05), and the quality of life through the SF-12 improved by 5 points, without statistical significance. No adverse effects were observed, and the adherence was 86.4%. Conclusions These studies demonstrated the efficacy of RFMCR together with TIM in reducing pain intensity and improving quality of life in patients with CPPS.