Endometriosis and musculoskeletal function of pelvic loin complex

Women with endometriosis may have lower pain threshold resulting in musculoskeletal dysfunction of pelvic loin complex.

Key Points

Highlights:

• Peripheral hypersensitivity in women with endometriosis, linked to new blood vessels and nerve growth, may impact musculoskeletal function.

• A multidisciplinary approach, including musculoskeletal assessment, is crucial for managing endometriosis and enhancing the quality of life.

What’s done here?

• This case-control study was conducted to assess musculoskeletal function in women having endometriosis and chronic pelvic pain.
• Clinical pain measurement tools including the Numerical Pain Rating Scale, the Visual Analogue Score (VAS), the digital algometer, the Tampa Scale for Kinesiophobia (TSK), and the Roland Morris Disability Questionnaire were used to compare women with and without endometriosis.
• Detailed musculoskeletal physiotherapeutic evaluation was performed including pain, pain on palpation, presence of trigger points, muscle flexibility, functionality, and kinesiophobia.
• Kinesiophobia is defined by the excessive, irrational, and debilitating fear of performing certain movements and physical activities, resulting in feelings of vulnerability to pain or in fear of recurrence of the injury.

Key results

• Seventy-one women who met the eligibility criteria were enrolled in this study: the endometriosis group (n=41) and the control group (n=30).
• Women in the endometriosis group had significantly less flexibility in the pelvic loin complex muscles, compared to healthy women.
• Based on pain mapping, the most prevalent pain areas were the hypogastrium in the endometriosis group and the left lumbar region in the control group.
• Significantly higher values were obtained in terms of kinesiophobia and disability, in the endometriosis group.
• There was a significant moderate and inverse correlation between kinesiophobia and the pressure threshold of pain in the pelvic loin region in the endometriosis group.

Strengths and Limitations

• This is the first study in the literature investigating the association between the kinesiophobia with functional impairment in people with endometriosis.

Lay Summary

Endometriosis is an inflammatory and estrogen-dependent disease which is diagnosed in reproductive-aged women most frequently. These women present with a broad clinical spectrum including pelvic pain, dysmenorrhea, dyspareunia and infertility.

All of these symptoms and signs may harm women’s lives having endometriosis. Because of peripheral hypersensitivity, these women may have musculoskeletal dysfunction located in the pelvic loin complex.   

Silva de Barros et al., from Brazil, published a study titled as “Musculoskeletal evaluation of the lower pelvic complex in women with endometriosis: A case-control study” in the European Journal of Obstetrics & Gynecology and Reproductive Biology.

The authors aimed to assess how endometriosis would affect the function of the musculoskeletal system in pelvic pain complex. They performed detailed musculoskeletal physiotherapeutic evaluations including pain, pain on palpation, presence of trigger points, muscle flexibility, functionality, and kinesiophobia. They used clinical measurement tools such as the Numerical Pain Rating Scale, the Visual Analogue Score (VAS), the digital algometer, the Tampa Scale for Kinesiophobia, and the Roland Morris Disability Questionnaire. Women with endometriosis were detected to have a higher prevalence of musculoskeletal disorder, lower pain thresholds, decreased lumbopelvic muscle range of motion, higher kinesiophobia scores, and increased disability indices with low back pain compared to healthy women.

 “Multidisciplinary approach searching the lumbar-pelvic complex has important implications for the evaluation and treatment of endometriosis.” the authors added.  

Research Source: https://pubmed.ncbi.nlm.nih.gov/38959628/