Assessing Kinesiophobia and Catastrophizing Patient-Reported Outcomes in a Randomized Controlled Trial: Efficacy of Capacitive-Resistive Monopolar Radiofrequency Combined with Myofascial Techniques vs. Sham Radiofrequency in Chronic Pelvic Pain Syndrome—A Secondary Analysis

Introduction and Hypothesis: Chronic Pelvic Pain Syndrome causes psychological distress, worsened by kinesiophobia and pain catastrophizing. This study assesses whether combining capacitive-resistive monopolar radiofrequency with myofascial techniques is more effective than myofascial techniques alone for improving psychological outcomes such as kinesiophobia and catastrophizing. Methods: This double-blind, randomized controlled trial enrolled 81 chronic pelvic pain syndrome patients (67.9% female, mean age 43.6 years) from March 2019 to April 2021. Participants were assigned to either an activated (intervention) or deactivated (control) capacitive-resistive monopolar radiofrequency group, with both groups receiving physiotherapy and pain education over 10 weeks. Outcomes on kinesiophobia and catastrophizing were assessed at weeks 5 and 10, using the Spanish versions of the Tampa Scale (TSK-11) and Pain Catastrophizing Scale (PCS). Results: At treatment’s end, the intervention group showed greater improvement in kinesiophobia (3 points) compared to controls, though nonsignificant (p =.099). The intervention also significantly reduced catastrophizing scores by 8 points versus control (p =.042). No major adverse effects occurred, and adherence was high (86.4%), with no differences between groups. Conclusion: This study shows that combining capacitive-resistive monopolar radiofrequency with myofascial techniques can improve kinesiophobia and catastrophizing in chronic pelvic pain syndrome patients, such as fear movement and catastrophic thinking related to pain. This marks a potential breakthrough in chronic pain management. Future research should focus on larger, multicenter RCTs with extended follow-up periods to better assess long-term effects. Registration: Clinical trial registration (NCT03797911).