The presence of abnormal palpatory findings in the sacrococcygeal area is correlated with chronic pelvic pain: a cross-sectional study.

OBJECTIVE

This study examines the prevalence of abnormal palpatory findings (APFs) in the different pelvic areas among individuals with chronic pelvic pain syndrome (CPP-CPPS) and assesses correlations between APFs and clinical and psychosocial symptoms.

METHODS

In this cross-sectional study, 326 participants (162 CPP-CPPS patients, 164 controls) underwent a standardized palpatory assessment of the sacroiliac, sacrococcygeal, and pelvic floor regions. The manual procedure was performed by two expert physiotherapists with a certification in osteopathic manipulation, following a consensus training. We assessed symptom severity and psychosocial variables using the NIH Chronic Prostatitis Symptom Index (NIH-CPSI), the Hospital Anxiety and Depression Scale (HADS), and the Fear Avoidance Belief Questionnaire (FABQ). Correlation analyses explored relationships between APFs, the presence of pain, and psychosocial variables.

RESULTS

APFs were significantly associated with CPP/CPPS, particularly in the sacrococcygeal (r = 0.609, p < 0.01) and pelvic floor (r = 0.620, p < 0.01) regions, indicating a moderate-to-strong correlation. The multivariate analysis confirmed that sacrococcygeal APFs (OR 3.02, 95% CI 1.96-4.65, p < 0.001) and pelvic floor APFs (OR 2.99, 95% CI 1.87-4.78, p < 0.001) were independently associated with CPP/CPPS, whereas sacroiliac findings showed a weak correlation. The correlations between APFs and psychosocial issues (anxiety, depression, fear-avoidance) were weak (r = 0.25).

CONCLUSIONS

Sacrococcygeal and pelvic floor APFs appear to be important clinical markers of CPP/CPPS. Their presence may help identify patients who could benefit from targeted manual therapy as part of multimodal management. Further research should evaluate the prognostic value of these findings.