Effect of Myofascial Release Combined With Acupressure on BL23 On Chronic Perineal Pain

All females in both groups will follow self-care and lifestyle advice for 4 weeks.

Females in the experimental group will receive intravaginal myofascial release in lithotomic position. After ensuring empty bladder/bowel, therapist uses sterile gloves and lubricant to insert fingers 2-3cm into vagina, pressing vaginal walls bilaterally for 2 minutes. Perineal massage follows, targeting scar tissue and tender points with friction at right angles. Treatment duration starts at 5 minutes (due to pain tolerance) and gradually increases to 20 minutes. Hot pack or ultrasound may be used pre-treatment for pain relief. Therapist performs gentle U-shaped reciprocating massage movements up and down towards rectum for 20 minutes total. Sterile technique maintained throughout with hand washing and glove changes between procedures.

"Each female in the experimental group will receive acupressure on BL 23 as follows: Acupressure is also another branch of acupuncture. In this method, fingers press the key points on the skin to stimulate and induce the body's natural self-healing capabilities. In the present study, the BL23 point located 1.5 cm lateral to the lower border of the spinous process of the second lumbar vertebra was employed.~The therapist will apply pressure on BL 23 points with the thumb for 5 minutes in the counterclockwise direction. In the second 5 minutes, pressure was applied in the opposite direction for 5 minutes. Similarly, the pressure was continued for 20 minutes."