Biofeedback Effective Levator Ani Syndrome Treatment

Teaches pelvic floor muscle relaxation; reduces pain more than electrogalvanic stimulation, massage
By Beth Gilbert
HealthDay Reporter

FRIDAY, April 9 (HealthDay News) -- Biofeedback to teach relaxation of the pelvic floor muscles is more effective than electrogalvanic stimulation (EGS) or levator muscle massage for the treatment of levator ani syndrome (LAS), according to a study published in the April issue of Gastroenterology.

Giuseppe Chiarioni, M.D., of the University of Verona in Italy, and colleagues randomized 157 patients with weekly pain to either nine sessions including psychologic counseling plus biofeedback, EGS, or massage of levator muscles, with outcomes reassessed at one, three, six and 12 months. Patients were categorized as "highly likely" to have LAS if they reported tenderness with traction on levator muscles or "possible" LAS if they did not.

Among patients with "highly likely" LAS, the researchers found that adequate relief was reported by 87 percent of patients who underwent biofeedback, 45 percent treated with EGS, and 22 percent who underwent massage. Pain days per month decreased the most from baseline among patients who were treated with biofeedback, followed by EGS, and then massage. Pain intensity, on a scale of zero to 10, decreased from 6.8 at baseline to 1.8 after biofeedback, 4.7 after EGS, and 6.0 after massage. Patients with "possible" LAS did not benefit from biofeedback, EGS or massage.

"Regarding clinical application, this study demonstrates that biofeedback is an effective treatment that can be recommended for the treatment of LAS," the authors write. "Of equal value to clinicians, our data show that digital massage, a treatment frequently recommended for LAS, is ineffective and should be abandoned. EGS was significantly less effective than biofeedback but may retain a role in the treatment of LAS when biofeedback therapy is not available."

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