Clinical Scorecard: A Systematic Review and Meta-Analysis of Physiotherapy Interventions for Pelvic Pain Related to Endometriosis
At a Glance
Category
Detail
Condition
Endometriosis-associated pelvic pain
Key Mechanisms
Chronic inflammatory condition with ectopic endometrial tissue causing pelvic pain; physiotherapy techniques provide anti-inflammatory and analgesic effects
Target Population
Women of reproductive age diagnosed with endometriosis experiencing pelvic pain
Care Setting
Outpatient physiotherapy and clinical pain management settings
Key Highlights
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 show the greatest pain reduction effect (MD −2.03, 95% CI −3.9 to −0.14).
Locally applied physiotherapy techniques result in greater pain relief than generally applied techniques.
Guideline-Based Recommendations
Diagnosis
Diagnose endometriosis-associated pelvic pain using validated pain measurement scales such as Visual Analog Scale (VAS) or Numerical Rating Scale (NRS).
Management
Consider physiotherapy techniques as an effective non-pharmacological treatment option for pelvic pain related to endometriosis.
Employ local physiotherapy modalities (e.g., electrotherapy, laser therapy) to maximize pain reduction.
Use physiotherapy as part of a holistic management approach alongside pharmacological treatments.
Monitoring & Follow-up
Assess pain changes before and after physiotherapy interventions using standardized pain scales (VAS, NRS).
Monitor patient-reported outcomes to evaluate effectiveness and adjust treatment plans accordingly.
Risks
Be aware of potential side effects and contraindications associated with long-term pharmacotherapy; physiotherapy offers fewer side effects.
Ensure exclusion of non-conventional therapies (e.g., yoga, acupuncture) when focusing on physiotherapy efficacy.
Patient & Prescribing Data
Women diagnosed with endometriosis experiencing chronic pelvic pain.
Physiotherapy techniques, especially electrotherapy and laser modalities applied locally, provide significant pain relief and may serve as effective alternatives or adjuncts to pharmacological treatments.
Clinical Best Practices
Use validated 0-to-10-point pain scales (VAS, NRS) to measure pelvic pain severity pre- and post-physiotherapy.
Prefer local application of physiotherapy modalities for enhanced analgesic effect.
Incorporate physiotherapy into multidisciplinary care plans for endometriosis-associated pelvic pain.
Educate patients on the benefits and limitations of physiotherapy as a complementary treatment option.
Avoid non-conventional interventions when assessing physiotherapy efficacy in clinical practice.
by Gökçe Can, Isabel Pinto Amorim das Virgens, Boglárka Fehér, Enikő Pálma Orbán, Péter Fehérvári, Ferenc Bánhidy, Péter Hegyi, Ágnes Andrea Mayer, Nándor Ács
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