The primary outcome was the referred pain distribution as indicated in pain maps and the secondary outcome was the size of the referred pain areas. The aim of this study was to describe the referred pain patterns provoked from 13 predetermined intra-pelvic anatomical landmarks in parous women with CPP and contrast those patterns with those provoked in parous women without CPP. This knowledge may be of value for the differential diagnosis of CPP. The distribution of referred pain patterns provoked from intra-pelvic structures has, as far as we know, not previously been comprehensively described in women with CPP. The pelvic ligaments, muscles and/or their insertions have been proposed as sources of CPP. Validation of pain mapping has been assessed with a systematic review. The methodology has been used previously for identifying sclerotomal innervation and also for the evaluation of CPP. Pain mapping is a method to investigate the distribution of referred pain. Knowledge of these patterns can assist in understanding the source of CPP in women.
In terms of location, there is considerable location discrepancy between dermatomes and sclerotomes particularly in the body trunk and proximal limbs. Sclerotome charts have been reported in humans but more extensively in rats.
#TRAVELL AND SIMONS REFERRED PAIN PATTERNS SKIN#
A sclerotome is defined as an area of bone and periosteum supplied by a single spinal segment, in contrast to dermatome and myotome as areas of skin and muscle supplied by a single spinal segment. Referred pain patterns elicited from skeletal and myofascial tissue has been studied from the beginning of 19 th century in different settings. Referred pain can be provoked from tendons, ligaments, visceral and skeletal structures as well as from myofascial structures. It is defined by the International Association for the Study of Pain (IASP) as “pain perceived at a location that is not the origin of the pain”. Referred pain is a well-known phenomenon that may occur in any pain condition. One type of CPP is pregnancy-related and 2–5% of all parous women experience disabling dysfunction two years after childbirth. These women routinely consult gynecologists for evaluation often without any gynecological abnormalities being found on examination. In 1996 it was estimated that $881.5 million dollars were spent annually in the United States on outpatient visits alone. Symptoms vary widely implying that CPP derives from different structures in different individuals and sexes suggesting a multifactorial source of pain, including the pejorative explanation that it is “functional”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.Ĭhronic pelvic pain (CPP) is a major therapeutic challenge for healthcare providers such as general practitioners, physiotherapists and specialized physicians and it is often difficult to reach a definitive diagnosis. All other data are available for researchers who meet the criteria for access to confidential data.įunding: This study was supported by grants from the Västernorrland County Council and Medical Faculty, Uppsala University. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedĭata Availability: All pain drawings are available from the Figshare database ( ).
Received: SeptemAccepted: JanuPublished: March 20, 2015Ĭopyright: © 2015 Torstensson et al. PLoS ONE 10(3):Īcademic Editor: Theodore John Price, University of Texas at Dallas, UNITED STATES Citation: Torstensson T, Butler S, Lindgren A, Peterson M, Eriksson M, Kristiansson P (2015) Referred Pain Patterns Provoked on Intra-Pelvic Structures among Women with and without Chronic Pelvic Pain: A Descriptive Study.
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