Ultrasonographic identification of pelvic floor myofascial trigger points and their correlation with clinical symptoms in patients with pelvic floor myofascial pain.

BACKGROUND

Pelvic floor myofascial pain (MFP) is a common yet often underdiagnosed condition, and the clinical significance of ultrasonographically identified myofascial trigger points (MTrPs) remains insufficiently understood. The aim of this study was to assess the correlation between ultrasonographically identified MTrPs and clinical manifestations of pelvic floor MFP.

METHODS

A retrospective review was conducted on medical records of 70 patients diagnosed with MFP at Yiwu Traditional Chinese Medicine Hospital between January 2024 and June 2025. MTrPs in the obturator internus, piriformis, levator ani, and coccygeus muscles were identified using transvaginal ultrasonography. Pain scores were recorded, and correlation analyses were conducted to examine the relationships between the distribution of MTrP and reported pain symptoms.

RESULTS

Dyspareunia was significantly correlated with MTrPs in the left piriformis muscle (ρ =0.222, P=0.013). Vaginal pain was significantly associated with MTrPs in the right coccygeus and right piriformis muscles (ρ =0.216 and 0.217, both P<0.05). Left groin pain was correlated with MTrPs in the bilateral levator ani and left obturator internus muscles (ρ =0.197, 0.226, and 0.184, all P<0.05). Buttock pain, low back pain, and lower abdominal pain bilaterally demonstrated significant correlations with MTrPs in the coccygeus, piriformis, and levator ani muscles (ρ values ranging from 0.179 to 0.825, all P<0.05).

CONCLUSIONS

Transvaginal ultrasonography-identified trigger point-like findings may be associated with specific pain distributions, suggesting a potential role for ultrasound-guided assessment in understanding pelvic floor pain patterns and contributing to improved pain management and quality of life among patients with MFP.