Prevalence of neuropathic pain and pelvic floor disorders among females seeking physical therapy for chronic low back pain

Abstract

Aims: Female patients often seek physical therapy (PT) for chronic low back pain (CLBP). This study aimed to evaluate the prevalence of pelvic floor disorder (PFD) and the association between PFD and neuropathic pain (NP) in a population of women referred to PT for CLBP, as these parameters are rarely investigated in this context. Materials and Methods: This cross-sectional survey study included women aged 30–60 years who were referred to PT for CLBP. In addition to demographic and clinical information, the patients completed structured assessment questionnaires such as the validated Pelvic Floor Distress Inventory (PFDI-20), which was used to determine the prevalence of PFD, and the self-completed Leeds Assessment of Neuropathic Symptoms and Signs to differentiate nociceptive pain from NP. Results: Among the 225 women included in the study, the mean body mass index was 31.6 ± 4.7 and the mean age was 46.7 ± 7.7 years (~79% were older than 40 years). The majority were not employed (i.e., homemakers), currently married, and sexually active. In addition, almost all had children (approximately 69% were grand multiparous), the majority of whom had been delivered through spontaneous vaginal delivery. Approximately 33% of women were postmenopausal and only 3% used hormone replacement therapy. Slightly more than half suffered from NP and approximately 43% experienced at least one PFD. Notably, patients with NP had significantly higher PFDI-20 overall and subscale scores, compared to those without NP. Conclusions: Although PFD and NP are not routinely assessed in PT practice, both conditions are prevalent among and may interact in women with CLBP.

Keywords

• Chronic low back pain
• Neuropathic pain
• Pelvic Floor Distress Inventory
• pelvic floor dysfunctions
• physical therapy