Rapid and sustained resolution of scrotal content pain through multimodal integrative neuromuscular interventions
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Background
Scrotal content pain (SCP) is a common and significant clinical challenge that significantly impairs quality of life. SCP appears to be caused by mechanical dysfunction of the lower abdominal wall, inguinal canal, or pelvic floor, which can lead to compressive neuropathy of the ilioinguinal and genitofemoral nerves creating a persistent pain-spasm cycle. Previous interventions have typically focused on either pain or muscle dysfunction individually, rather than using an integrative approach to address both aspects.
Aims
To report outcomes of a novel, multimodal, integrative neuromuscular protocol for men with SCP in a retrospective case series.
Methods
Twenty eight men (mean age 42.1±14.9 years) with chronic SCP underwent four weekly treatment sessions of a multimodal protocol consisting of class IV laser therapy, dry needling, pulsed electromagnetic field therapy, manual therapy, progressive therapeutic exercises, and oral tadalafil 5mg. Pain was measured using a Visual Analog Scale (VAS) before and after each session. Physical and mental health were assessed using the NIH PROMIS Global-10.
Results
VAS pain decreased significantly from 8.0±0.6 cm at baseline to 3.0±1.1 cm after the first session. By the end of the 4-week protocol, VAS pain was 0.8±0.8 cm. The PROMIS Global-10 Physical Health score increased by 27%, and the Mental Health score increased by 9.4%. Pain and PROMIS score improvements exceeded established MCIDs.
Conclusion
Patients with SCP can achieve rapid, significant, and sustained pain relief and quality of life improvements using a multimodal therapeutic approach that is superior to monotherapies.
