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Clinical effectiveness of the obturator externus muscle injection in chronic pelvic pain patients

 Shin Hyung Kim  ;  Do Hyeong Kim  ;  Duck Mi Yoon  ;  Kyung Bong Yoon 
 PAIN PRACTICE, Vol.15(1) : 40-46, 2015 
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Adult ; Aged ; Anesthetics, Local/therapeutic use* ; Chronic Pain/drug therapy* ; Contrast Media ; Female ; Fluoroscopy ; Humans ; Injections, Intramuscular ; Lidocaine/therapeutic use* ; Male ; Middle Aged ; Muscle, Skeletal ; Obturator Nerve ; Pain Measurement ; Patient Satisfaction ; Pelvic Pain/drug therapy* ; Pelvis ; Retrospective Studies ; Treatment Outcome ; Trigger Points ; Young Adult
chronic pain ; hip joint ; injections ; intramuscular ; myofascial pain syndromes ; obturator externus ; obturator nerve ; pelvic pain
BACKGROUND: Because of its anatomical location and function, the obturator externus (OE) muscle can be a source of pain; however, this muscle is understudied as a possible target for therapeutic intervention in pain practice. In this retrospective observational study, we evaluated the clinical effectiveness of the OE muscle injection with a local anesthetic in chronic pelvic pain patients with suspected OE muscle problems. METHODS: Twenty-three patients with localized tenderness on the inferolateral side of the pubic tubercle accompanied by pain in the groin, anteromedial thigh, or hip were studied. After identifying the OE with contrast dye under fluoroscopic guidance, 5 to 8 mL of 0.3% lidocaine was injected. Pain scores were assessed before and after injection; patient satisfaction was also assessed. RESULTS: Mean pain score decreased by 44.7% (6.6 ± 1.8 to 3.5 ± 0.9, P < 0.001) 2 weeks after OE muscle injection as compared with pain score before injection. In addition, 82% of patients (19 of 23 patients) reported excellent or good satisfaction during 2 weeks after injection. No patients reported complications from OE muscle injection. CONCLUSIONS: Fluoroscopy-guided injection of the OE muscle with local anesthetic reduced pain scores and led to a high level of satisfaction at short-term follow-up in patients with suspected OE muscle problem. The results of this study suggest that OE muscle injection may be a valuable therapeutic option for a select group of chronic pelvic pain patients who present with localized tenderness in the OE muscle that is accompanied by groin, anteromedial thigh, or hip pain.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Hyeong(김도형) ORCID logo https://orcid.org/0000-0003-2018-8090
Kim, Shin Hyung(김신형) ORCID logo https://orcid.org/0000-0003-4058-7697
Yoon, Kyoung Bong(윤경봉) ORCID logo https://orcid.org/0000-0002-4167-1375
Yoon, Duck Mi(윤덕미)
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