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Complementary and Alternative (CAM) Treatment Options for Women with Pelvic Pain

  • Women’s Health Rehabilitation (S Bennis and C Fitzgerald, Section Editors)
  • Published:
Current Physical Medicine and Rehabilitation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To provide an overview of the current complementary and alternative (CAM) treatment options for women with chronic pelvic pain (CPP).

Recent Findings

Recent studies on chronic pain at cellular, molecular, and network level and their interaction with the immune system have unfolded several mechanisms for pain making it promising to explore the alternative paradigm to manage the incredibly complex chronic pelvic pain condition where multifactorial etiology often limits successful outcomes.

Summary

The multifactorial nature and complexity in establishing the underlying diagnosis in CPP limit predictable response to traditional medical and interventional options. Complementary and alternative options have been studied to improve outcomes. Incorporation of exercise-based CAM, pelvic floor physical therapy, acupuncture, and cognitive behavioral therapy are suggested to show promising results, but well powered randomized studies are needed to draw conclusions on their efficacy. Evidence for non-opioid alternatives such as oral cannabinoids are preliminary and may emerge to be safe and effective.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rana N, Drake MJ, Rinko R, Dawson M, Whitmore K. The fundamentals of chronic pelvic pain assessment, based on international continent society recommendations. Neurourol Urodyn. 2018;37(S6):S32–8. https://doi.org/10.1002/nau.23776.

    Article  PubMed  Google Scholar 

  2. Grundy L, Brierley SM. Cross-organ sensitization between the colon and bladder: to pee or not to pee? Am J Physiol Gastrointest Liver Physiol. 2018;314(3):G301–8. https://doi.org/10.1152/ajpgi.00272.2017 Epub 2017 Nov 16.

    Article  PubMed  CAS  Google Scholar 

  3. Inoue K, Tsuda M. Microglia in neuropathic pain: cellular and molecular mechanisms and therapeutic potential. Nat Rev Neurosci. 2018;19(3):138–52. https://doi.org/10.1038/nrn.2018.2 Epub 2018 Feb 8.

    Article  PubMed  CAS  Google Scholar 

  4. Bliss TV, Collingridge GL, Kaang BK, Zhuo M. Synaptic plasticity in the anterior cingulate cortex in acute and chronic pain. Nat Rev Neurosci. 2016;17(8):485–96. https://doi.org/10.1038/nrn.2016.68 Epub 2016 Jun 16.

    Article  PubMed  CAS  Google Scholar 

  5. Ernst E, Pittler M. Expert’s opinions on complementary/alternative therapies for low back pain. J Manip Physiol Ther. 1999;22(2):87–90.

    Article  CAS  Google Scholar 

  6. Wolsko PM, Eisenberg DM, Davis RB, Kessler R, Phillips RS. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine (Phila Pa 1976). 2003;28(3):292–7 discussion 298.

    Google Scholar 

  7. Foltz V, St Pierre Y, Rozenberg S, Rossignol M, Bourgeois P, Joseph L, et al. Use of complementary and alternative therapies by patients with self-reported chronic back pain: a nationwide survey in Canada. Joint Bone Spine. 2005;72(6):571–7 Epub 2005 Sep 7.

    Article  Google Scholar 

  8. Hughes CM, Liddle SD, Sinclair M, McCullough JEM. The use of complementary and alternative medicine (CAM) for pregnancy related low back and/ or pelvic girdle pain. Complement Ther Clin Pract. 2018;31:379–83. https://doi.org/10.1016/j.ctcp.2018.01.015 Epub 2018 Feb 2.

    Article  PubMed  Google Scholar 

  9. •• FitzGerald MP, Payne CK, Lukacz ES, et al. Randomized multicenter clinical trial of myofascial physical therapy in women with interstitial cystitis/painful bladder syndrome and pelvic floor tenderness J Urol. 2012;187(6):2113-2118. https://doi.org/10.1016/j.juro.2012.01.123. Epub 2012 Apr 12. This is a multicenter RCT that showed a significant difference in the myofascial pelvic floor therapy over global therapeutic massage (59% versus 26%) without any significant major adverse effects in women with symptomatic IC/painful bladder syndrome who had pelvic floor tenderness on examination.

  10. •• Fitzgerald MP, Anderson RU, Potts J, et al. Randomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes. J Urol. 2013;189(1 Suppl):S75–85. https://doi.org/10.1016/j.juro.2012.11.018This study was a reasonably large RCT (23 men and 24 women) with chronic prostatitis/CPPS that showed excellent adherence to the two different manual therapy protocols- myofascial and therapeutic massage and showed statistically significant improvement on global response rate for the myofascial therapy group.

    Article  PubMed  Google Scholar 

  11. Vural M. Role of birth in pelvic floor dysfunction, postpartum exercises and kegel exercises. In: Karan A, editor. Physical therapy and rehabilitation in urogynecology. Istanbul: Nobel Tip Kitabevleri; 2016. p. s127–47.

    Google Scholar 

  12. •• Vural M. Pelvic pain rehabilitation. Turk J Phys Med Rehabil. 2018 64(4):291–299. https://doi.org/10.5606/tftrd.2018.3616. eCollection 2018 Dec. This is a review article discussing the multifactorial nature of the problem and quoting several articles on the pelvic floor myofascial therapy, kinetic chain assessment and pelvic floor retraining that has shown to be helpful in urological pelvic pain and pelvic floor pain.

  13. Tyler TF, Fukunaga T, Gellert J. Rehabilitation of soft tissue injuries of the hip and pelvis. Int J Sports Phys Ther. 2014 Nov;9(6):785–97.

    PubMed  PubMed Central  Google Scholar 

  14. Arnouk A, De E, Rehfuss A, Cappadocia C, Dickson S, Lian F. Physical, complementary, and alternative medicine in the treatment of pelvic floor disorders. Curr Urol Rep. 2017 Jun;18(6):47. https://doi.org/10.1007/s11934-017-0694-7.

    Article  PubMed  Google Scholar 

  15. •• Ghaderi F, Bastani P, Hajebrahimi S, Jafarabadi MA, Berghmans B. Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial. Int Urogynecol J. 2019 30(11):1849–1855. https://doi.org/10.1007/s00192-019-04019-3. Epub 2019 Jul 8. This is a recent randomized study of 64 women with dyspareunia with the 32 women in the experimental group received electrotherapy, manual therapy and PFM exercises while the control group received no treatment. They showed statistically significant improvement in endurance, PFM< strength and female sexual function index score in the experimental group.

  16. • Scott KM, Fisher LW, Bernstein IH, et al. The treatment of chronic coccydynia and postcoccygectomy pain with pelvic floor physical therapy. PM R. 2017 9(4):367–376. https://doi.org/10.1016/j.pmrj.2016.08.007. Epub 2016 Aug 24. This retrospective chart review of 124 patients with chronic coccydynia concluded that there is level 3 evidence that pelvic floor PT was safe and effective in the treatment of coccydynia. Of the 79 patients who completed treatment, the mean average pain ratings decreased from 5.08 to 1.91 (p < 0.001) and mean percentage global improvement rate was 71.9%.

  17. •• Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019;31(6):485–93. https://doi.org/10.1097/GCO.0000000000000584This is a recent review article reporting on evidences in support for pelvic floor physical therapy and recommending as first line treatment for most pelvic floor disorders.

    Article  PubMed  Google Scholar 

  18. Lee SW, Liong ML, Yuen KH, Leong WS, Chee C, et al. Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med. 2008;121(1):79. e1–7. https://doi.org/10.1016/j.amjmed.2007.07.033.

    Article  Google Scholar 

  19. Ohlsen BA. Acupuncture and traditional Chinese medicine for the management of a 35-year-old man with chronic prostatitis with chronic pelvic pain syndrome. J Chiropr Med. 2013;12(3):182–90. https://doi.org/10.1016/j.jcm.2013.10.004.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lee SH, Lee BC. Use of acupuncture as a treatment method for chronic prostatitis/chronic pelvic pain syndromes. Curr Urol Rep. 2011;12(4):288–96. https://doi.org/10.1007/s11934-011-0186-0.

    Article  PubMed  CAS  Google Scholar 

  21. Antolak SJ. Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2004;63(1):212. https://doi.org/10.1016/j.urology.2003.09.037.

    Article  PubMed  Google Scholar 

  22. Liddle CE, Harris RE. Cellular reorganization plays a vital role in acupuncture analgesia. Med Acupunct. 2018;30(1):15–20. https://doi.org/10.1089/acu.2017.1258.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lathia AT, Jung SM, Chen LX. Efficacy of acupuncture as a treatment for chronic shoulder pain. J Altern Complement Med. 2009;15(6):613–8. https://doi.org/10.1089/acm.2008.0272.

    Article  PubMed  Google Scholar 

  24. • Sung SH, Sung AD, Sung HK, An TE et al. Acupuncture treatment for chronic pelvic pain in women: a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2018; 2018:9415897. https://doi.org/10.1155/2018/9415897. eCollection 2018. This meta-analysis identified 4 RCT’s involving 474 women and showed that the methodological quality was low in these trials and in 2 studies, there was evidence to show that acupuncture with conventional treatment is more effective that acupuncture alone based on total effectiveness but there is insufficient evidence to suggest that acupucture can be recommended as a CAM option in CPP in women.

  25. World Health Organization, WHO Standard Acupuncture Point Locations in the Western Pacific Region, WHO Western Pacific Region, Geneva, Switzerland, 2008.

  26. Wayne PM, Kerr CE, Schnyer RN, Legedza ATR, Savetsky-German J, Shields MH, et al. Japanese-style acupuncture for endometriosis-related pelvic pain in adolescents and young women: results of a randomized sham-controlled trial. J Pediatr Adolesc Gynecol. 2008;21(5):247–57. https://doi.org/10.1016/j.jpag.2007.07.008.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Rubi-Klein K, Kucera-Sliutz E, Nissel H, Bijak M, Stockenhuber D, Fink M, et al. Is acupuncture in addition to conventional medicine effective as pain treatment for endometriosis? A randomised controlled cross-over trial. Eur J Obstet Gynecol Reprod Biol. 2010;153(1):90–3. https://doi.org/10.1016/j.ejogrb.2010.06.023 Epub 2010 Aug 21.

    Article  PubMed  Google Scholar 

  28. • Moldwin RM, Fariello JY. Myofascial trigger points of the pelvic floor: associations with urological pain syndromes and treatment strategies including injection therapy. Curr Urol Rep. 2013;14(5):409–17. https://doi.org/10.1007/s11934-013-0360-7Reported that myofascial trigger points and contraction knots are seen in 85% of women with urological, colorectal and gynecological pelvic pain and suggested aggressive injection interventions such as trigger point injections with anesthetics, dry needling and Botox in refractory cases.

    Article  PubMed  Google Scholar 

  29. Oyama IA, Rejba A, Lukban JC, Fletcher E, Kellogg-Spadt S, Holzberg AS, et al. Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction. Urology. 2004;64(5):862–5.

    Article  Google Scholar 

  30. Montenegro ML, Mateus-Vasconcelos EC, Candido dos Reis FJ, Rosa e Silva JC, Nogueira AA, Poli Neto OB. Thiele massage as a therapeutic option for women with chronic pelvic pain caused by tenderness of pelvic floor muscles. J Eval Clin Pract. 2010;16(5):981–2. https://doi.org/10.1111/j.1365-2753.2009.01202.x.

  31. Silva AP, Montenegro ML, Gurian MB, Mitidieri AM, Lara LA, Poli-Neto OB, et al. Perineal massage improves the dyspareunia caused by tenderness of the pelvic floor muscles. Rev Bras Ginecol Obstet. 2017;39(1):26–30. https://doi.org/10.1055/s-0036-1597651 Epub 2016 Dec 27.

    Article  PubMed  Google Scholar 

  32. Franke H, Franke J-D, Fryer G. Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2014;15:286. Published online 2014 Aug 30. https://doi.org/10.1186/1471-2474-15-286.

    Article  PubMed  PubMed Central  Google Scholar 

  33. • Franke H, Franke JD, Belz S, Fryer G. Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: a systematic review and meta-analysis. J Bodyw Mov Ther. 2017 21(4):752–762. https://doi.org/10.1016/j.jbmt.2017.05.014. Epub 2017 May 31. This meta-analysis on RCT’s completed on the effectiveness of OMT for treating low back pain identified 5 studies in pregnant women with moderate quality evidence to suggest significant medium sized effect in reduction of pain and 3 studies in postpartum women that had low quality evidence for moderate pain reduction.

  34. Origo D, Tarantino AG. Osteopathic manipulative treatment in pudendal neuralgia: a case report. J Bodyw Mov Ther. 2019;23(2):247–50. https://doi.org/10.1016/j.jbmt.2018.02.016 Epub 2018 Feb 17.

    Article  PubMed  CAS  Google Scholar 

  35. • Holtzman S, Beggs RT. Yoga for chronic low back pain: a meta-analysis of randomized controlled trials. Pain Res Manag. 2013 18(5):267–272. Epub 2013 Jul 26. This study identified 8 RCT’s involving 743 women where yoga was used as an intervention to manage chronic low back pain and showed that Yoga had medium to large effect on functional disability and pain however with a moderately large variability in the effect sizes and recommended future trials should include an active control group to determine the actual effects of Yoga versus conventional therapy in chronic LBP.

  36. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133:581–624.

    Article  Google Scholar 

  37. Field T. Yoga clinical research review. Complement Ther Clin Pract 2011 Feb;17(1):1–8. https://doi.org/10.1016/j.ctcp.2010.09.007. Epub 2010 Oct 14, 1.

  38. • Saxena R, Gupta M, Shankar N, Jain S, Saxena A. Effects of Yogic intervention on pain scores and quality of life in females with chronic pelvic pain. Int J Yoga. 2017;10(1):9–15. https://doi.org/10.4103/0973-6131.186155. This RCT on 60 women with chronic pelvic pain showed significant decrease in VAS score in the 30 patients who received yogic intervention for 8 weeks and improvement in quality of life based on World Health Organization quality of life-BREF (WHOQOL-BREF) questionnaire compared to women with conventional therapy with NSAID’s.

    Article  PubMed  PubMed Central  Google Scholar 

  39. • Gray C, McCormack S. Yoga for chronic non-malignant pain management: a review of clinical effectiveness, cost-effectiveness and guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019 Jul. CADTH Rapid Response Reports. This summary of evidence regarding clinical and cost effectiveness on yoga as an intervention for non-malignant chronic pain found no evidence to suggest it is cost-effective compared to conventional treatment and found 7 guidelines of moderate to high methodological quality in favor of yoga.

  40. Park J, Krause-Parello CA, Barnes CM. A narrative review of movement-based mind-body interventions: effects of yoga, Tai Chi, and Qigong for back pain patients. Holist Nurs Pract. 2020;34(1):3–23. https://doi.org/10.1097/HNP.0000000000000360.

    Article  PubMed  Google Scholar 

  41. Doğa MD. The effect of reiki on pain: a meta-analysis. Complement Ther Clin Pract. 2018;31:384–7. https://doi.org/10.1016/j.ctcp.2018.02.020 Epub 2018 Mar 10.

    Article  Google Scholar 

  42. •• Eller-Smith OC, Nicol AL, Christianson JA. Potential mechanisms underlying centralized pain and emerging therapeutic interventions. Front Cell Neurosci. 2018 12:35. https://doi.org/10.3389/fncel.2018.00035. eCollection 2018. This review article discusses the potential mechanisms of centrally driven pain amplification and emerging non pharmacological measures to improve outcomes in patients with central pain syndrome.

  43. Theoharides TC, Flaris N, Cronin CT, Ucci A, Meares E. Mast cell activation in sterile bladder and prostate inflammation. Int Arch Allergy Appl Immunol. 1990;92:281–6. https://doi.org/10.1159/000235190.

    Article  PubMed  CAS  Google Scholar 

  44. Amir T, Pai RR, Raghuveer CV. Mast cell profile in prostatic lesions. Indian J Med Sci. 1998;52:507–13.

    PubMed  CAS  Google Scholar 

  45. Leclair CM, Goetsch MF, Korcheva VB, Anderson R, Peters D, Morgan TK. Differences in primary compared with secondary vestibulodynia by immunohistochemistry. Obstet Gynecol. 2011;117:1307–13. https://doi.org/10.1097/AOG.0b013e31821c33dc.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Salomons TV, Moayedi M, Erpelding N, Davis KD. A brief cognitive-behavioural intervention for pain reduces secondary hyperalgesia. Pain. 2014;155(8):1446–52. https://doi.org/10.1016/j.pain.2014.02.012 Epub 2014 Feb 22.

    Article  PubMed  Google Scholar 

  47. Miller-Matero LR, Saulino C, Clark S, Bugenski M, Eshelman A, Eisenstein D. When treating the pain is not enough: a multidisciplinary approach for chronic pelvic pain. Arch Womens Ment Health. 2016;19(2):349–54. https://doi.org/10.1007/s00737-015-0537-9 Epub 2015 May 5.

    Article  PubMed  Google Scholar 

  48. Romão AP, Gorayeb R, Romão GS, et al. High levels of anxiety and depression have a negative effect on quality of life of women with chronic pelvic pain. Int J Clin Pract. 2009;63(5):707–11. https://doi.org/10.1111/j.1742-1241.2009.02034.x.

  49. •• Siqueira-Campos VME, Da Luz RA, de Deus JM, Martinez EZ, Conde DM Anxiety and depression in women with and without chronic pelvic pain: prevalence and associated factors. J Pain Res. 2019 12:1223–1233. https://doi.org/10.2147/JPR.S195317. eCollection 2019. This cross-sectional study of 100 women with CPP and 100 women without CPP (pain free controls) studied the prevalence of anxiety and depression in this population and found that the prevalence of anxiety disorders were 66% in CPP versus 49% in control group and depression was 63% versus 38%. CPP, physical and sexual abuse were independently associated with depression.

  50. Reynolds WM, Coats KI. A comparison of cognitive-behavioral therapy and relaxation training for the treatment of depression in adolescents. J Consult Clin Psychol. 1986;54:653–60. https://doi.org/10.1037/0022-006x.54.5.653.

    Article  PubMed  CAS  Google Scholar 

  51. Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry. 2008;69:621–32. https://doi.org/10.4088/jcp.v69n0415.

  52. • Champaneria R, Daniels JP, Raza A, Pattison HM, Khan KS. Pschycological therapies for chronic pelvic pain: systematic review of randomized controlled trials. Acta Obstet Gynecol Scand. 2012 91(3):281–286. https://doi.org/10.1111/j.1600-0412.2011.01314. x. Epub 2012 Jan 9. First systematic review of RCT’s on psychological therapies in the treatment of chronic pelvic pain that identified 4 studies reporting that although some studies show a positive effect and showed reduction in pain scores, it is not possible to conclude that psychological interventions causes decrease in self-reported pain scores in these women at this time.

  53. Meissner K, Schweizer-Arau A, Limmer A, Preibisch C, Popovici RM, Lange I, et al. Psychotherapy with somatosensory stimulation for endometriosis-associated pain: a randomized controlled trial. Obstet Gynecol. 2016;128(5):1134–42.

    Article  CAS  Google Scholar 

  54. Goldfinger C, Pukall CF, Thibault-Gagnon S, McLean L, Chamberlain S. Effectiveness of cognitive-behavioral therapy and physical therapy for provoked vestibulodynia: a randomized pilot study. J Sex Med. 2016;13(1):88–94. https://doi.org/10.1016/j.jsxm.2015.12.003.

    Article  PubMed  Google Scholar 

  55. Capodice JL, Bemis DL, Buttyan R, Kaplan SA, Katz AE. Complementary and alternative medicine for chronic prostatitis/chronic pelvic pain syndrome. Evid Based Complement Alternat Med. 2005;2(4):495–501 Epub 2005 Oct 10.

    Article  Google Scholar 

  56. Gagnier JJ, Oltean H, van Tulder MW, Berman BM, Bombardier C, Robbins CB. Herbal medicine for low back pain: a Cochrane review. Spine (Phila Pa 1976). 2016 Jan;41(2):116–33. https://doi.org/10.1097/BRS.0000000000001310.

    Article  Google Scholar 

  57. • Morgia G, Russo GI, Urzì D, Privitera S, et al. A phase II, randomized, single-blinded, placebo-controlled clinical trial on the efficacy of Curcumina and Calendula suppositories for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome type III. Arch Ital Urol Androl. 2017;89(2):110–3. https://doi.org/10.4081/aiua.2017.2.110. This RCT studied 48 men randomized to rectal suppositories of Curcumin extract 350 mg (95%) and Calendula extract 80 mg (1 suppository/die for 1 month). Patients of group B received 1 suppository/die for 1 month of placebo. There was significant reduction in NIH-CPSI score and VAS score in the treatment group.

    Article  PubMed  CAS  Google Scholar 

  58. Simsek M, Burak F, Taskin O. Effects of micronized purified flavonoid fraction (Daflon) on pelvic pain in women with laparoscopically diagnosed pelvic congestion syndrome: a randomized crossover trial. Clin Exp Obstet Gynecol. 2007;34(2):96–8.

    PubMed  CAS  Google Scholar 

  59. • Mücke M, Phillips T, Radbruch L, Petzke F, Häuser W. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2018;3:CD012182. https://doi.org/10.1002/14651858.CD012182.pub2. A review of all randomized double-blind controlled studies on medical cannabis, plant derived and synthetic cannabinoids reported in analyzing 16 studies with 1750 participants, there is low quality evidence to suggest that cannabis may increase the number of people to achieve more than 50% reduction and very low quality evidence to suggest improvement in patient global impression of change. The benefits of cannabis may outweigh the risks in chronic neuropathic pain but no evidence was found on the long-term risks.

    Article  PubMed  Google Scholar 

  60. Vadivelu N, Kai AM, Kodumudi V, Sramcik J, Kaye AD. The opioid crisis: a comprehensive overview. Curr Pain Headache Rep. 2018;22(3):16. https://doi.org/10.1007/s11916-018-0670-z.

    Article  PubMed  Google Scholar 

  61. Abrams DI, Couey P, Shade SB, Kelly ME, Benowitz NL. Cannabinoid-opioid interaction in chronic pain. Clin Pharmacol Ther. 2011;90(6):844–51. https://doi.org/10.1038/clpt.2011.188 Epub 2011 Nov 2.

    Article  PubMed  CAS  Google Scholar 

  62. Andreae MH, Carter GM, Shaparin N, Suslov K, et al. Inhaled cannabis for chronic neuropathic pain: a meta-analysis of individual patient data. J Pain. 2015;16(12):1221–32. https://doi.org/10.1016/j.jpain.2015.07.009 Epub 2015 Sep 9.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Aviram J, Samuelly-Leichtag G. Efficacy of cannabis-based medicines for pain management: a systematic review and meta-analysis of randomized controlled trials. Pain Physician. 2017 Sep;20(6):E755–96.

    PubMed  CAS  Google Scholar 

  64. Mukerji G, Yiangou Y, Agarwal SK, Anand P. Increased cannabinoid receptor 1-immunoreactive nerve fibers in overactive and painful bladder disorders and their correlation with symptoms. Urology. 2010;75(6):1514.e15–20. https://doi.org/10.1016/j.urology.2009.12.051 Epub 2010 Mar 25.

    Article  Google Scholar 

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Funding

Donald McGeary, PhD, ABPPNCCIH; PI: McGeary: R01 AT008422

Donald McGeary reports grants from the National Center for Complementary and Integrative Health during the conduct of the study.

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Correspondence to Ameet S. Nagpal.

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Donald McGeary reports grants from the National Center for Complementary and Integrative Health during the conduct of the study.

Malathy Srinivasan, Joseph Torres, and Ameet Nagpal declare that they have no conflicts of interest.

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Srinivasan, M., Torres, J.E., McGeary, D. et al. Complementary and Alternative (CAM) Treatment Options for Women with Pelvic Pain. Curr Phys Med Rehabil Rep 8, 240–248 (2020). https://doi.org/10.1007/s40141-020-00264-6

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