Pelvic inflammatory disease (PID) and upper genital tract infection describe inflammatory changes in the upper female genital tract of any of the following combination: endometritis, salpingitis, tubo-ovarian abscess and peritonitis in the small pelvis and in most cases the infection is ascending. The spectrum ranges from sub-clinical, asymptomatic infection to severe, life-threatening illness.
The symptoms of PID are recurrent and chronic abdominal and pelvic pain, dyspareunia, dysmenorrhoea, menorrhagia, rectal discomfort and smelly vaginal discharge. Tubal sterility and ectopic pregnancy, tubo-ovarian abscess are the long term sequelae. Though, Chronic PID is no longer common in developed countries, but still poses a significant problem with chronic pain in the Third World.
The SWD is high-frequency electromagnetic waves (current is of high alternating frequency) that do not stimulate motor or sensory nerve; it is a form of radiofrequency radiation, operating at a frequency of 27.12 MHz, used therapeutically by physiotherapists. It is ideal for heating tissues as deeply placed in the pelvis as the female reproductive organs.
Lamina et al (2011) conducted a double blind pre test – post test study to investigate the efficacy of SWD in the symptomatic management of pain and anti-inflammatory role in 32 chronic PID patients. Patients were randomly assigned to three groups: SWD, control and analgesic groups.
A continuous shortwave diathermy current was generated by the Shortwave diathermy machine (Ultratherm 608) adopting the modified crossfire technique. This involved moving electrodes to a position at right angles to their previous position half way through treatment. In this way, half the treatment was given antero-posteriorly through the pelvis with the patients in supine lying position and second half with the patients in the side lying positions with their legs curled up and the electrodes over the pelvic outlets and the lumbo-sacral area of the spine. Treatment was given every alternative days for a total of 15 exposures of 20 minutes each.
Other groups; Analgesic group received antibiotics, Analgesics and sham SWD; while the control group received antibiotics, sham SWD and placebo tablets. The study lasted for a period of 30 days.
Findings of the study revealed significant effect of SWD over analgesic and control in pain responses and resolution of inflammation at p < 0.05. It was concluded that SWD may be an effective and non invasive therapy in the management of chronic PID pain.
Reference: Lamina S et L (2011) Short wave diathermy in the symptomatic management of chronic pelvic inflammatory disease pain: A randomized controlled trial. Physiotherapy Research International, 16(1),50–56.