Endometriosis is a common inflammatory condition that can cause pelvic pain, fatigue, and infertility, affecting 1 in 10 females during their reproductive years. It occurs when endometrial tissue (lining of the uterus) grows outside of the uterus. The causes are not fully understood but genetic factors can influence risk of developing the condition. Early detection is important as delayed diagnosis can lead to infertility, debilitating pain and reduced quality of life.

Signs and Symptoms:

  • Severe dysmenorrhoea (period pain)
  • Recurring or persistent pelvic pain >6 months
  • Dyspareunia (painful sex)
  • Back or leg pain
  • Heavy, irregular or extended periods
  • Dark or old blood passed at the beginning or end of period
  • Pain before, during or after emptying bladder or bowels
  • Chronic fatigue
  • Bloating
  • Infertility
  • Nausea
  • Depression

Treatment:

  • Analgesics – including paracetamol and anti-inflammatories (NSAIDS)
  • Surgery – There is no definite cure for endometriosis however surgical excision or ablation are the gold standard treatment.
  • Hormone-based treatments – These can include the pill, progesterone hormone medication, a Mirena, Gonadotrophin-releasing hormone implants and sprays.
  • Alternative therapies – such as acupuncture, transcutaneous electrical nerve stimulation (TENS), magnesium, Vitamins B1 and B6
  • Physiotherapy – pain management, bladder and bowel management, manual therapy, exercise, education, relaxation, taping and TENS

Physiotherapy management:

  • Manual therapy
  • Internal manual therapy
  • Pain education
  • Exercise program prescription
  • Relaxation techniques
  • Taping and TENS

Massage and manual therapy can be utilised as short term pain relief. As a women’s health physiotherapist, we are trained in internal vaginal examinations to assess overactivity and tightness of the pelvic floor muscles. Internal pelvic floor releases have been shown to help in the pain relief caused by endometriosis. [4]

Physiotherapists have undergone training in how to explain and educate pain mechanics. Understanding pain and how it affects the body can help to process sensations and manage pain long term. Additionally, relaxation techniques can help calm nervous system reducing the intensity of pain sensations.

Physiotherapists are experts in how the body moves and how physical activity can help improve your health and pain. Research shows that undergoing a specific exercise program targeted to stabilising your lower back muscles and abdominal strengthening may improve lower back pain experienced with endometriosis. The research indicates that an 8 week exercise program may help improve the strength surrounding these structures. This improvement in strength can help to decrease pain experienced, however more research is needed to confirm significant findings. [2]

A technique that can be taught to you by your physiotherapist to help with menstrual cramps is taping. Taping has been shows to improve blood circulation to the areas of the skin covered by the tape and normalise muscle function. [1]

These are a few ways that your physiotherapist can work with your medical team to help with the management of your endometriosis.  By introducing regular exercise, relaxation techniques and taping it may be effective in helping improve quality of life of those affected by endometriosis [2].

The Physiotherapists at Bump Fitness have completed training in Women’s Health and are ready to help you with any of your pelvic related pains. Get in touch with us today to book your appointment and get on top of your health!

 

References

  1. Lim, C. etal 2013. The Effect of the Kinesio Taping and Spiral Taping on Menstrual Pain and Premenstrual Syndrome ncbi.nlm.nih.gov/pmc/articles/PMC3820414/#_ffn_sectile
  2. Salinas-Asensio,M. etal 2022. Physio-EndEA Study: A Randomised, Parallel-Group Controlled Trial to Evaluate the Effect of a Supervised and Adapted Therapeutic Exercise Program T0 improve Quality of Life in Symptomatic Women Diagnosed with Endometriosis. https://www.mdpi.com/1660-4601/19/3/1738
  3. Tennfjord, M et al. 2021 Effect of Physical Activity and Exercise on Endometriosis-associated symptoms: a systematic review Wojcik,M et al. 2022. Physiotherapy Management in Endometriosis. https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01500-4
  4. Wojcik,M et al. 2022. Physiotherapy Management in Endometriosis. https://www.mdpi.com/1660-4601/19/23/16148