5.5 million reproductive-aged women in the United States have received an endometriosis diagnosis, which is defined as the presence of endometrial tissue outside the uterine cavity.
This diagnosis is associated with severe and chronic pelvic pain that is typically associated with a menstrual cycle, inflammation, scarring, and infertility. In addition to the physical pain that endometriosis brings, receiving this diagnosis can cause a great deal of emotional pain and distress. However, we are here to shed some light on solutions and how physical therapy can help.
Inflammation, scar tissue, and adhesion formations can make for an optimal environment of increased muscle and fascial (connective tissue) tension. The secondary effects of muscle and fascial tension can then perpetuate the cycle of pain and decrease overall mobility. This is where physical therapy can play a role; by addressing the tension within the pelvis and abdominal wall, we are able to promote freer motion and decrease the secondary dysfunction. Keeping this in mind, the typical symptoms we see patients for in regards to endometriosis are:
- Dysmenorrhea (painful periods)
- Pelvic pain between periods
- Dyspareunia (painful penetrative intercourse)
- Dysuria (painful urination)
- Constipation or diarrhea
- Rectal spasms
The treatments enacted by your physical therapist are all aimed at slowing the process of the disease and not curing it. Currently, there is no cure for endometriosis other than a complete disruption and ending of the reproductive process (i.e. hysterectomy). There are other options before moving to this extreme option, however.
Physical therapy for endometriosis will focus on pain management techniques that include manual therapy, stretching, deep abdominal breathing, visceral manipulation, trigger point release, and self-care suggestions. Endometriosis disease is definitely a team effort; we, as physical therapists, will not be the only part of your team, but will coordinate with a gastroenterologist (GI) doctor, endocrinologist doctor, counselor, and of course you!
Receiving this diagnosis is not easy and treatment is a process. Treatment is handled best with a team of professionals to help guide you. Let us be a part of that team and assist in the process.
American Society of Reproductive Medicine: asrm.org
Endometriosis Foundations of America: endofound.org