physioscience 2014; 10(1): 3-7
DOI: 10.1055/s-0033-1356009
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Myofasziale Triggerpunkttherapie reduzierte die Symptome bei einem männlichen Patienten mit Proctalgia fugax

FallstudieMyofascial Trigger Point Therapy Reduced Symptoms in a Male Patient with Proctalgia FugaxCase Study
W. Demmer
1   SOMT Pelvic Education, CH-Interlaken
,
J. Taeymans
1   SOMT Pelvic Education, CH-Interlaken
2   Berner Fachhochschule, Fachbereich Gesundheit, CH-Bern
,
J. H. de Jong
1   SOMT Pelvic Education, CH-Interlaken
› Author Affiliations
Further Information

Publication History

03 June 2013

01 July 2013

Publication Date:
03 March 2014 (online)

Zusammenfassung

Hintergrund: Die Rom-III-Kriterien definieren Proctalgia fugax als eine periodisch auftretende Schmerzepisode im anorektalen Bereich. Myofasziale Triggerpunkttherapie (MTrT) umfasst manuelle Kompressions- und Dehnungstechniken zur Schmerzlinderung in den myofaszialen Strukturen.

Ziel: Diese prospektive Fallstudie beschreibt den MTrT-Verlauf bei einem 50-jährigen Mann mit Proctalgia fugax.

Methode: Der Patient wurde bezüglich seiner klinischen Symptomatik sowie der Anatomie und der Funktion des Beckenbodens aufgeklärt. Die Behandlung bestand aus MTrT in Kombination mit einer Schulung der Beckenbodenwahrnehmung und Entspannung.

Ergebnisse: Nach 8 Behandlungen hatten sich Frequenz- und Schmerzintensitätsepisoden der Proctalgia fugax reduziert.

Schlussfolgerungen: MTrT erzielt eine substanzielle Reduktion der Symptome bei den in dieser Fallstudie behandelten Patienten. Um die Effektivität von MTrT bei Proctalgia fugax weiter zu untersuchen, sind randomisierte kontrollierte Studien von hoher Qualität notwendig.

Abstract

Background: The Rome III criteria define Proctalgia fugax as a periodically occurring pain episode in the anorectal area. Myofascial triggerpoint therapy (MTrT) implies manual compression and stretching techniques for pain release in myofascial structures.

Objective: This prospective case study describes a MTrT course in the case of a 50-year-old male patient with Proctalgia fugax.

Method: The patient was informed in terms of clinical symptoms as well as pelvic floor anatomy and function. Treatment consisted of MTrT along with training in pelvic floor perception and relaxation.

Results: After 8 treatment sessions frequency and pain intensity episodes of proctalgia fugax had decreased.

Conclusions: MTrT produces substantial symptom reduction in the patients of this case study. For further examination of MTrT effectiveness high quality randomized controlled trials are necessary.

 
  • Literatur

  • 1 Anderson RU, Wise D, Sawyer T et al. Integration of Myofascial Trigger Point Release and Paradoxical Relaxation Training Treatment of Chronic Pelvic Pain in Men. J Urol 2005; 174: 155-160
  • 2 Anderson RU, Sawyer T, Wise D et al. Painful Myofascial Triggerpoints and Pain Sites in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome. J Urol 2009; 182: 2753-2758
  • 3 Atkin GK, Suliman A, Vaizey CJ. Patient Characteristics and Treatment Outcome in Functional Anorectal Pain. Dis Colon Rectum 2011; 54: 870-875
  • 4 Childs JD, Piva SR, Fritz MS et al. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine 2005; 30: 1331-1334
  • 5 Cornel EB, van Haarst EP, Schaarsberg RW et al. The Effect of Biofeedback Physical Therapy in Men with Chronic Pelvic Pain Syndrome Type III. European Urology 2005; 47: 607-611
  • 6 Damphousse M, Jousse M, Verollet D et al. Proctalgies fugaces et neuropathie pudendale: étude neurophysiologique périnéale chez 55 patients. Progrès en Urologie 2012; 22: 220-224
  • 7 Dommerholt J, Bron C, Fransen J. Myofasziale Triggerpunkte, Evidenzbasierter Review. manuelletherapie 2011; 15: 1-13
  • 8 FitzGerald MP, Kotarinos R. Rehabilitation of the short pelvic floor. I: Background and patient evaluation. Int Urogynecol J 2003; 14: 261-268
  • 9 FitzGerald MP, Kotarinos R. Rehabilitation of the short pelvic floor. II: Treatment of the patient with the short pelvic floor. Int Urogynecol J 2003; 14: 269-275
  • 10 FitzGerald MP, Anderson RU, Potts J et al. Randomized Multicenter Feasibility Trial of Myofascial Therapy for Treatment of Urologic Chronic Pelvic Pain Syndrome. J Urol 2009; 182: 570-580
  • 11 FitzGerald MP, Payne CK, Lukacz ES et al. Randomized Multicenter Clinical Trial of Myofascial Physical Therapy in Women with Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS) and Pelvic Floor Tenderness. J Urol 2012; 187: 2113-2118
  • 12 Gautschi R. Manuelle Triggerpunkt-Therapie. Myofasziale Schmerzen und Funktionsstörungen erkennen, verstehen und behandeln. Stuttgart: Thieme; 2010
  • 13 Grape HH, Dedering A, Jonasson AT. Retest reliability of surface electromyography on the pelvic floor muscles. Neurol Urodyn 2009; 28: 395-399
  • 14 Gröbli C, Dejung B. Nichtmedikamentöse Therapie myofaszialer Schmerzen. Schmerz 2003; 17: 475-480
  • 15 Hayes RB, Deveraux PJ, Guyatt GH. Physicians’ and patients’ choices in evidence based practice. BMJ 2002; 324: 1350
  • 16 Herr KA, Spratt K, Mobily PR et al. Pain intensity assessment in older adults: use of experimental pain to compare psychometric properties and usability of selected pain scales with younger adults. Clin J Pain 2004; 20: 207-219
  • 17 Itza F, Zarza D, Serra L et al. Myofascial pain syndrome in the pelvic floor: A common urological condition. Actas Urolesp 2010; 34: 318-326
  • 18 Jeyarajah S, Chow A, Ziprin P et al. Proctalgia fugax, an evidence-based management pathway. Int J Colorectal Dis 2010; 25: 1037-1046
  • 19 Marhauer S. Clinical Reasoning in der Physiotherapie. physiopraxis 2003; 7: 18-21
  • 20 Messelink B, Benson T, Bergmans B et al. Standardization of terminology of pelvic floor muscle function and dysfunction: Report from the Pelvic Floor Clinical Assessment Group of the International Continence Society. Neurol Urodyn 2005; 24: 374-380
  • 21 Partanen VJ, Ojala TA, Arakoski JPA. Myofascial syndrome and pain: A neurophysiological approach. Pathophysiology 2010; 17: 19-28
  • 22 Rome Foundation. Rome III Diagnostic Criteria for Functional Gastrointestinal Disorders. 2006 www.romecriteria.org/assets/pdf/19_RomeIII_apA_885-898.pdf (03.06.2013)
  • 23 Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ et al. Face validity and reliability of the first digital assessment scheme of pelvic floor muscle function conform the new standardized terminology of the International Continence Society. Neurol Urodyn 2009; 28: 295-300
  • 24 Streibelt M, Schmidt C, Brünger M et al. Komorbidität im Patientenurteil – geht das? Validität eines Instruments zur Selbsteinschätzung der Komorbidität (SCQ-D). Orthopädie 2012; 41: 303-310
  • 25 Tait R, Pollard C, Margolis R et al. Pain disability index: psychometric and validity data. Arch Phys Med Rehabil 1987; 68: 438-441
  • 26 Travell J, Simons D. Myofascial Pain and Dysfunction – The Trigger Point Manual. Vol. 1. Philadelphia: Williams & Wilkins; 1983
  • 27 Travell J, Simons D. Myofascial Pain and Dysfunction – The Trigger Point Manual. Vol. 2. Philadelphia: Williams & Wilkins; 1992
  • 28 Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs 2005; 14: 798-804