Widespread Pain Hypersensitivity and Lumbopelvic Impairments in Women Diagnosed with Endometriosis

Ana Lara-Ramos, Lara-Ramos A, Francisco Álvarez-Salvago, Álvarez-Salvago F, Carolina Fernández-Lao, Fernández-Lao C, Noelia Galiano-Castillo, Galiano-Castillo N, Olga Ocón-Hernández, Ocón-Hernández O, Maryna Mazheika, Mazheika M, Salinas-Asensio MM, Ma Mar Salinas-Asensio, Mundo-López A, Antonio Mundo-López, Manuel Arroyo-Morales, Arroyo-Morales M, Irene Cantarero‐Villanueva, Irene Cantarero-Villanueva, Francisco Artacho‐Cordón, Francisco Artacho-Cordón
Pain medicine (Malden, Mass.) · 2021 · doi:10.1093/pm/pnaa463 · PMID:33675228
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-13 ⓘ

Women with endometriosis exhibited widespread pain hypersensitivity and lumbopelvic impairments, including reduced muscle thickness and stability, with severity linked to endometriosis stage.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This cross-sectional study assessed pain hypersensitivity and lumbopelvic musculoskeletal impairments in 66 women, including 41 diagnosed with endometriosis and 25 healthy controls. Using numeric rating scales and the Pain Catastrophizing Scale, the authors found that women with endometriosis reported higher current pelvic pain intensity, had reduced local pressure pain thresholds, and showed a higher prevalence of lumbar nerve root impingement/irritation pain and catastrophizing thoughts, with similar associations strengthening alongside endometriosis stage and pain severity. They also reported that affected participants had decreased transversus abdominis thickness, reduced trunk flexor/extensor muscle resistance, and lower lumbopelvic stability. This paper is centrally about endometriosis — it directly characterizes widespread pain hypersensitivity and lumbopelvic impairments in women diagnosed with endometriosis.

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Abstract

OBJECTIVE: To explore hypersensitivity to pain and musculoskeletal impairments in the lumbopelvic area in women with and without endometriosis. METHODS: This cross-sectional study included 66 women (41 women with endometriosis and 25 healthy women). Pain and related catastrophizing thoughts were assessed through a numeric rating scale, pressure pain thresholds (PPTs), the slump test, and the Pain Catastrophizing Scale. Lumbopelvic muscles were evaluated through ultrasound imaging, flexor/extensor resistance tests, and the lumbopelvic stability test. RESULTS: Women with endometriosis showed increased self-reported intensity of current pelvic pain (CuPP), reduced local PPTs (42.8-64.7% in the affected area, P-value <.001) and higher prevalence of lumbar nerve root impingement/irritation pain and catastrophizing thoughts (P-value ≤.002). Moreover, affected women showed decreased thickness of transversus abdominis, reduced resistance of flexor and extensor trunk muscles and lower lumbopelvic stability (P-values <.030). Endometriosis stage and severity of CuPP were related to worse results in these parameters. CONCLUSIONS: The presence of pain sensitization signs and lumbopelvic impairments, more pronounced in patients with stage IV endometriosis and moderate/severe CuPP, warrants the development of rehabilitation interventions targeting pain and lumbopelvic impairments in women with endometriosis.
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Abstract

Objective: To explore hypersensitivity to pain and musculoskeletal impairments in the lumbopelvic area in women with and without endometriosis.

Methods

This cross-sectional study included 66 women (41 women with endometriosis and 25 healthy women). Pain and related catastrophizing thoughts were assessed through a numeric rating scale, pressure pain thresholds (PPTs), the slump test, and the Pain Catastrophizing Scale. Lumbopelvic muscles were evaluated through ultrasound imaging, flexor/extensor resistance tests, and the lumbopelvic stability test.

Results

Women with endometriosis showed increased self-reported intensity of current pelvic pain (CuPP), reduced local PPTs (42.8-64.7% in the affected area, P-value <.001) and higher prevalence of lumbar nerve root impingement/irritation pain and catastrophizing thoughts (P-value ≤.002). Moreover, affected women showed decreased thickness of transversus abdominis, reduced resistance of flexor and extensor trunk muscles and lower lumbopelvic stability (P-values <.030). Endometriosis stage and severity of CuPP were related to worse results in these parameters.

Conclusions

The presence of pain sensitization signs and lumbopelvic impairments, more pronounced in patients with stage IV endometriosis and moderate/severe CuPP, warrants the development of rehabilitation interventions targeting pain and lumbopelvic impairments in women with endometriosis.

Keywords

Abdominal Muscles; Back Muscles; Endometriosis; Lumbopelvic Stability; Pain Pressure Threshold; Pelvic Pain. Descripción Palabras clave Abdominal Muscles, Back Muscles, Endometriosis, Lumbopelvic Stability, Pain Pressure Threshold, Pelvic Pain Citación Lara-Ramos A, Álvarez-Salvago F, Fernández-Lao C, Galiano-Castillo N, Ocón-Hernández O, Mazheika M, Salinas-Asensio MM, Mundo-López A, Arroyo-Morales M, Cantarero-Villanueva I, Artacho-Cordón F. Widespread Pain Hypersensitivity and Lumbopelvic Impairments in Women Diagnosed with Endometriosis. Pain Med. 2021 Sep 8;22(9):1970-1981. doi: 10.1093/pm/pnaa463. PMID: 33675228.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Cross-Sectional Studies Female Health Status Humans Pain

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