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Can Patients Use Internal Trigger Point Devices Safely?

The team associated with what was formerly called "The Stanford Protocol" for pelvic pain has evaluated the use of an internal wand by patients. This trigger point wand was designed to help the patient apply appropriate amounts of pressure as it has in its design an algometer for measuring pressure. 113 of 157 enrolled (mostly male) patients completed 6 months of wand use, the authors point out that those who dropped out of the study did not withdraw due to adverse affects from using the wand. Patients were instructed in use of the wand and carefully supervised prior to using the device on their own. They were instructed to use the wand several times per week. Visual analog scale measurements were taken at baseline and at 6 months. The baseline median sensitivity was 7.5 and decreased to 4 at 6 months. Over 95% of the patients reported that the wand was very or moderately effective in relieving pain.

This pilot study addresses some very important concerns. Although it is a pilot study, this work addresses the need for research to support aspects of pelvic pain therapy programs. Very importantly, it addresses the issue of how much pressure patients are using when applying self-trigger point releases with a device. We have all met patients who, despite our best coaching, apply so much pressure with any self-treatment that the symptoms meant to be alleviated are worsened, usually accompanied by the phrase, "I don't know what you did last time, but..."

Until such a device used in this study is available to clinicians, it will be difficult to gauge how much pressure a patient is applying with a device such as a wand. As in this study, patients who wish to use a trigger point tool should be carefully instructed in safe techniques for use of such a device. These trigger point tools may continue to be helpful in self-care and home program participation by the patient.

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