Exploring the Changes in Pain Quality, Mechanical Allodynia, and Tactile Sensibility in Women With Persistent Postpartum Perineal Pain Treated With Somatosensory Rehabilitation: A Retrospective Case Series

探讨采用体感康复治疗持续性产后会阴疼痛女性的疼痛性质、机械性痛觉过敏和触觉敏感性的变化:一项回顾性病例系列研究

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Abstract

Background Persistent postpartum perineal pain (PPPP) is a prevalent condition characterized by provoked, unprovoked, or mixed pain. Somatosensory rehabilitation has shown significant effects in alleviating provoked pain, and, more specifically, mechanical allodynia, in other populations. Therefore, this method could be a promising approach for the treatment of PPPP. This study aims to describe changes in pain quality, mechanical allodynia, and tactile sensibility in women with PPPP treated with somatosensory rehabilitation. Methodology This retrospective case series describes the use of a somatosensory rehabilitation method applied to the treatment of PPPP. This intervention mainly involved tactile stimulation to treat pain, mechanical allodynia, and tactile sensibility. The study included individual outcomes of nine eligible patients treated with this method. Outcome measures included pain quality (Questionnaire de la douleur Saint-Antoine), surface (allodynography with a 15.0-g monofilament), and severity of mechanical allodynia (Rainbow Pain Scale), as well as tactile sensibility (pressure perception threshold, static two-point discrimination test, vibration perception threshold). Results All patients showed a reduction in pain quality score and resolution of mechanical allodynia in the vulva, defined by the criteria of no significant exacerbation of pain upon touch with a 15.0-g Semmes-Weinstein monofilament. Sensibility assessments revealed an improvement in tactile hypoesthesia in the area of the skin where allodynia was previously present. Conclusions This study shows promising results for the use of somatosensory rehabilitation in the treatment of PPPP. Further randomized controlled studies are needed to investigate its efficacy in this population.

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