Physiotherapy Effectively Reduces Pelvic Pain in Endometriosis: Systematic Review & Meta-Analysis

Overview

This systematic review and meta-analysis of 8 studies demonstrates that physiotherapy techniques significantly reduce pelvic pain in women with endometriosis. Physiotherapy modalities, especially electrotherapy and laser devices, and locally applied techniques showed the greatest pain reduction compared to non-physiotherapy interventions.

Background

Endometriosis is a chronic inflammatory condition affecting approximately 10% of women of reproductive age worldwide, often causing chronic pelvic pain that severely impacts quality of life. Current pharmacological treatments, such as NSAIDs and analgesics, have limitations including side effects and contraindications. There is a growing need for alternative or adjunctive therapies. Physiotherapy, with known anti-inflammatory and analgesic effects, may offer a beneficial non-pharmacological option for managing endometriosis-associated pelvic pain.

Data Highlights

Key Findings

• Physiotherapy techniques significantly reduce pelvic pain in women with endometriosis compared to non-physiotherapy interventions (MD −1.97, 95% CI −2.99 to −0.95).
• Physiotherapy modalities such as electrotherapy and laser devices provide the greatest pain relief among physiotherapy methods (MD −2.03, 95% CI −3.9 to −0.14).
• Locally applied physiotherapy techniques result in greater pain reduction than generally applied techniques.
• Seven out of eight included studies used standardized 0-to-10-point pain scales (VAS, NRS), ensuring comparability of pain outcomes.
• Physiotherapy offers a non-pharmacological alternative that may reduce reliance on NSAIDs and analgesics, potentially minimizing medication-related side effects.

Clinical Implications

Clinicians should consider incorporating physiotherapy, particularly modalities like electrotherapy and laser therapy, into the multidisciplinary management of endometriosis-associated pelvic pain. Local application of physiotherapy techniques may yield superior pain relief. This approach provides a valuable adjunct or alternative to pharmacological treatments, especially for patients contraindicated for or intolerant to standard medications.

Conclusion

Physiotherapy is an effective intervention for reducing pelvic pain in women with endometriosis, with locally applied modalities offering the greatest benefit. These findings support physiotherapy as a viable component of comprehensive endometriosis pain management.

References

1. Systematic Review and Meta-Analysis, 2023 -- A Systematic Review and Meta-Analysis of Physiotherapy Interventions for Pelvic Pain Related to Endometriosis