Physiotherapy for endometriosis-associated pelvic pain: a systematic review and meta-analysis

This systematic review and meta-analysis (PRISMA 2020; PROSPERO-registered) evaluated the effectiveness of physiotherapeutic interventions for endometriosis-associated pelvic pain in women with diagnosed endometriosis, using studies published up to November 2023 from PubMed, Embase, and the Cochrane Library. Eight studies (seven randomized trials and one retrospective study; 433 participants) met inclusion criteria, and seven were included in the meta-analysis; pain intensity had to be measured before and after treatment on a 0–10 scale (e.g., VAS/NRS), with interventions excluding non-physiotherapy approaches like yoga/Pilates or acupuncture. Overall, physiotherapy significantly reduced pelvic pain versus controls (MD −1.97, 95% CI −2.99 to −0.95), with physical measures such as TENS/transcranial electrotherapy/laser therapy showing the largest effects and laser therapy showing a marked reduction, while manual therapy and exercise therapy had smaller or limited effects; the authors reported moderate risk of bias and low certainty of evidence via GRADE. This paper is centrally about endometriosis — it is a systematic review and meta-analysis of physiotherapy techniques for endometriosis-associated pelvic pain.

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