The impact of multimodal physiotherapy in an interdisciplinary setting for the management of women with persistent pelvic pain and pelvic floor tension myalgia

Abstract

Purpose

To determine the effectiveness of multimodal physiotherapy in an interdisciplinary setting for the treatment of women with persistent pelvic pain (PPP) who have concomitant pelvic floor tension myalgia (PFTM).

Materials and methods

Prospective cohort study with 2-year follow-up at an interdisciplinary tertiary referral centre for PPP and endometriosis. Thirty-four women with PPP of gynaecological origin >6 months duration and PFTM on examination underwent individualised physiotherapy. Outcome measures were pain, measured by Visual Analogue Scale (VAS) on a scale of 0–100, quality of life assessed by AQoL-6D score range 0.0–1.0 and sexual function measured by the Female Sexual Function Index (FSFI).

Results

Participants attended a median of 4 physiotherapy sessions (range 1–11) with the median treatment duration 7 weeks (range: 1–16 weeks). Results at 3 months demonstrated a significant decrease in VAS scores for dysmenorrhoea (72.5 vs. 52, p=.015), low back pain (55 vs. 47.5, p=.004), dyschezia (45 vs. 30.5, p=.031), abdominal pain (52 vs. 36.5, p=.049) and non-menstrual pain (53 vs. 41, p=.018) with a non-significant decrease in dyspareunia (57 vs. 50, p=.365). At 2 years, improvements in dysmenorrhoea persisted (72.5 vs. 60, p=.002) and dyspareunia was significantly improved (57 vs. 36, p=.033). For the 11/24 (46%) women who had no medical or surgical co-intervention throughout the study duration, quality of life score was improved at 2 years compared with baseline (0.72 vs. 0.84, p=.002).

Conclusions

Physiotherapy may improve certain pain outcomes in the short and long term. It offers an additional treatment option for women with PPP.

Keywords:

• Persistent pelvic pain
• physiotherapy
• pelvic floor tension myalgia
• chronic pelvic pain
• endometriosis

Acknowledgements

The authors wish to acknowledge and thank the participants for their time and to Alana Healthcare for their support throughout the study in providing space and infrastructure. No payment was made to participants and no financial support was received from Alana Healthcare for this study.

Disclosure statement

No author has any conflict of interest relating to this manuscript. This research did not receive any specific grant from agencies in the public, commercial or not for profit sectors.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.