Brief Report  |   March 2019
Thermal and Mechanical Pain Thresholds of Women With Provoked Localized Vulvodynia: A Pilot Study
Author Notes
  • From the Departments of Biomedical Sciences (Dr Basha) and Clinical Sciences (Dr Nazar) at the West Virginia School of Osteopathic Medicine in Lewisburg; the Department of Obstetrics and Gynecology at Drexel University College of Medicine in Philadelphia, Pennsylvania (Drs Kellogg-Spadt, Ruberu, and Whitmore); the Department of Obstetrics and Gynecology at Summa Health System in Akron, Ohio (Dr Burrows); and the Department of Human Science, School of Nursing and Health Studies at Georgetown University in Washington, DC (Ms Wallach). 
  • Financial Disclosures: None reported. 
  • Support: This study was supported by a Professional Enrichment and Growth Award (Drexel University College of Medicine) and a National Vulvodynia Association Grant awarded to Dr Basha. 
  •  *Address correspondence to Maureen E. Basha, PhD, Department of Physiology, Louisiana State University Health Sciences Center, 1901 Perdido St, New Orleans, LA 70112-1393. Email: mbash1@lsuhsc.edu
     
Article Information
Neuromusculoskeletal Disorders / Obstetrics and Gynecology / Pain Management/Palliative Care
Brief Report   |   March 2019
Thermal and Mechanical Pain Thresholds of Women With Provoked Localized Vulvodynia: A Pilot Study
The Journal of the American Osteopathic Association, March 2019, Vol. 119, 164-172. doi:10.7556/jaoa.2019.027
The Journal of the American Osteopathic Association, March 2019, Vol. 119, 164-172. doi:10.7556/jaoa.2019.027
Abstract

Context: Vulvodynia is a chronic pain condition defined as vulvar pain lasting at least 3 months in the absence of gross anatomic or neurologic findings. Provoked, localized vulvodynia (PLV), a subtype of vulvodynia, is characterized by vestibular pain in response to light touch. The cause of PLV remains largely unknown, and triggering events have yet to be determined.

Objective: To evaluate vestibular and peripheral experimental pain thresholds in patients with PLV to further define the somatosensory profile of these patients.

Methods: After informed consent was provided, eligible participants completed a questionnaire and underwent quantitative sensory testing at the forearm and posterior vestibule. Detection and pain thresholds to thermal (cold and heat) and mechanical (pressure) stimuli were measured.

Results: Seventeen participants with PLV and 16 control participants were included. Participants in the PLV group scored lower on the patient health questionnaire 9 (PHQ-9) compared with those in the control group (P<.05) and had higher ratings of self-reported genital pain with sex (P<.001) and daily activity (P<.05). Forearm pain thresholds to cold (P<.01) and heat (P<.01) stimuli were also lower in the PLV group compared with those in the control group. Vestibular pain thresholds to cold (P<.05) and pressure (P<.01) stimuli were also lower in the PLV group.

Conclusion: Lower scores on the PHQ-9 and higher self-reported genital pain ratings of patients with PLV highlight the significant impact of this poorly understood condition on quality of life. Quantitative sensory testing results demonstrated that vestibular cold allodynia may be a somatosensory feature of PLV. Reduced forearm pain thresholds in these patients suggest altered sensory processing at extrapelvic sites, although it is unclear whether these measurements are related to central sensitization.

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