Analysis of Nociceptive Pain and Related Psychosocial Factors in Women With Endometriosis: A Cross-sectional Study

OBJECTIVES: The purpose of this study was to explore the associations and compare differences in abdominal and lumbar pain pressure thresholds, pelvic floor state, and pain- and movement-related psychosocial factors in women with and without endometriosis. METHODS: A cross-sectional study was conducted on women (18-50 years). Participants with endometriosis (EG) were compared to age-matched counterparts without endometriosis (CG). Clinical symptoms were recorded, and pain pressure thresholds (PPT) and pelvic floor muscles (PFM) tone and strength were measured. Psychosocial factors such as catastrophizing, kinesiophobia, sexual function, and health-related quality of life were assessed. Univariate and multivariate analyses of covariance were conducted. RESULTS: In total, 46 participants were analyzed (EG: 22; CG: 24). After isolating the effect of the participants' psychosocial factors, statistically significant differences between the groups regarding pain were still observed (P 0.14). EG participants had lower PPT in all abdominal and lumbar measurements (P 0.8). Sexual function and quality of life were significantly lower (P 0.8), while catastrophizing and kinesiophobia were significantly higher (P < .05; d ≥ 0.8) in the EG compared to CG. CONCLUSIONS: After isolating the effect of the psychological factors, pain remained a specific symptom of endometriosis. Woman with endometriosis had lower PPT in the lumbar and abdominal muscles, engaged more frequently in catastrophizing, kinesiophobia, and reported significantly lower quality of life. These findings underscore the need for a multidimensional approach that addresses both the physical and psychological aspects of women with endometriosis.