The role of physiotherapists in a novel interdisciplinary service treating women with endometriosis and chronic pelvic pain

This study describes the role of physiotherapists in a new interdisciplinary service for women with endometriosis and chronic pelvic pain. Descriptive report of the Endometriosis and Pelvic Pain Interdisciplinary Clinical Services (EPPICS) which is a novel interdisciplinary care program for women with endometriosis and pelvic pain in Queensland, Australia. This publicly funded service was launched in February 2024. EPPICS involves a team of healthcare professionals, including physiotherapists, offering personalised care tailored to each woman’s symptoms and goals. The role of physiotherapists in this interdisciplinary team involves enhancing pelvic floor muscle function, and addressing issues such as pelvic pain and the management of bladder, bowel, and sexual dysfunction. Preliminary data from February to April 2024 is presented, with plans to include in the conference presentation up to 12 months of data and its impact on patient reported outcomes. Within only three months of its launch, EPPICS had 124 patient visits. The physiotherapists were referred to 36 (29%) of the patients and conducted 103 appointments. Patients had an average of 3 sessions, with the potential for up to 8 sessions depending on symptom complexity. Patient assessment included real-time ultrasound and surface electromyography. Physiotherapy interventions included pain neuroscience education and pelvic floor muscle downtraining including biofeedback using mirrors, real-time ultrasound and surface electromyography. Soft tissue release and pelvic floor muscle exercises such as strengthening, and coordination training were also part of the interventions. Other strategies included bladder retraining, optimal defecation strategies, and sexual function improvement through desensitisation and graded exposure, which may have included dilator therapy. The use of devices such as pelvic floor TENS and pelvic wands was also discussed with the patients. Additionally, the physiotherapists promoted safe physical activity, including progressive exercise exposure, guided by the patient's activity level and its impact. Integrating physiotherapy into an interdisciplinary service for women with endometriosis and chronic pelvic pain provides a holistic approach to treatment, aiming to improve function and quality of life through pain management strategies and targeted interventions. Future research should explore the impact of involving physiotherapists in an interdisciplinary service on endometriosis-related outcomes. Physiotherapy care helps with delivering treatment to manage pain and pain-related disabilities at the Endometriosis and Pelvic Pain Interdisciplinary Clinic. If it is proven to improve service delivery and patient outcomes, integrating physiotherapy services could become a standard part of care for this group. Pelvic pain Health service