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Open Access Highly Accessed Research article

Toe spreading ability in men with chronic pelvic pain syndrome

Ugur Yilmaz1, Ivan Rothman2, Marcia A Ciol3, Claire C Yang1 and Richard E Berger1*

Author Affiliations

1 Department of Urology, University of Washington, Seattle, Washington, USA

2 Department of Urology, University of Washington, Seattle, Washington, USA

3 Rehabilitation Medicine, University of Washington, Seattle, Washington, USA

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BMC Urology 2005, 5:11  doi:10.1186/1471-2490-5-11

Published: 10 June 2005



We examined toe-spreading ability in subjects with chronic pelvic pain syndrome (CPPS) to test the hypothesis that subjects with CPPS could have deficiencies in lower extremity functions innervated by sacral spinal roots.


Seventy two subjects with CPPS and 98 volunteer controls were examined as part of a larger study on CPPS. All the subjects underwent a detailed urologic and neurological examination including a toe-spreading examination with a quantitative scoring system. We compared the groups in terms of ability of toe-spreading as either "complete" (all toes spreading) or "incomplete" (at least one interdigital space not spreading) and also by comparing the number of interdigital spaces. For CPPS subjects only, we also analyzed the variation of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scales by toe-spreading categories.


CPPS subjects were less often able to spread all toes than subjects without CPPS (p = 0.005). None of the NIH-CPSI sub-scales (pain, urinary symptoms, and quality of life), nor the total score showed an association with toe spreading ability.


We found toe spreading to be diminished in subjects with CPPS. We hypothesize that incomplete toe spreading in subjects with CPPS may be related to subtle deficits involving the most caudal part of the spinal segments.