Musculoskeletal Insights and Team-based Solutions for Chronic Pelvic Pain

Erin T Carey, E T Carey, Christine M. Chu, Lauren D Schiff, Lauren Schiff, Asha McClurg, Noor Dasouki Abu-Alnadi, Ingrid Harm-Ernandes, Colleen M. Fitzgerald
Clinical Obstetrics and Gynecology · 2026 · doi:10.1097/grf.0000000000001031 · PMID:42263299 · W7164018782
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-12 ⓘ

This paper highlights the prevalence of musculoskeletal issues in chronic pelvic pain, advocating for comprehensive assessment and multidisciplinary physical therapy while addressing barriers to wider implementation.

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This review highlights that musculoskeletal dysfunction is a prevalent but frequently overlooked contributor to chronic pelvic pain in women. It emphasizes the necessity of comprehensive assessments, including movement pattern analysis and pelvic floor examinations, alongside first-line treatments like physical therapy. The authors note that while multidisciplinary care optimizes outcomes, implementation is hindered by insurance gaps and limited specialist availability. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Chronic pelvic pain (CPP) affects up to 24% of women worldwide, with musculoskeletal pain and dysfunction present in most cases yet often overlooked in traditional organ-focused approaches. Comprehensive musculoskeletal assessment, including movement pattern analysis, pelvic floor examination, and evaluation of hip, spine, and abdominal wall pathology is essential for accurate diagnosis. First-line treatment with pelvic floor physical therapy demonstrates significant efficacy, though multidisciplinary team-based care optimizes outcomes through coordinated treatment plans. Despite evidence supporting this integrated approach, barriers including insurance coverage gaps, limited specialists, and insufficient musculoskeletal education prevent widespread implementation, necessitating advocacy, curriculum expansion, and systematic changes prioritizing comprehensive patient-centered care.
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Musculoskeletal Insights and Team-based Solutions for Chronic Pelvic Pain - Erin T. Carey* - Christine M. Chu† - Lauren D. Schiff* - Asha McClurg* - Noor Dasouki Abu-Alnadi* - Ingrid Harm-Ernandes† - Colleen M. Fitzgerald‡,§ Chronic pelvic pain (CPP) affects up to 24% of women worldwide, with musculoskeletal pain and dysfunction present in most cases yet often overlooked in traditional organ-focused approaches. Comprehensive musculoskeletal assessment, including movement pattern analysis, pelvic floor examination, and evaluation of hip, spine, and abdominal wall pathology is essential for accurate diagnosis. First-line treatment with pelvic floor physical therapy demonstrates significant efficacy, though multidisciplinary team-based care optimizes outcomes through coordinated treatment plans. Despite evidence supporting this integrated approach, barriers including insurance coverage gaps, limited specialists, and insufficient musculoskeletal education prevent widespread implementation, necessitating advocacy, curriculum expansion, and systematic changes prioritizing comprehensive patient-centered care.

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License: CC0 · commercial use OK