The role of reflexology in the comprehensive rehabilitation of patients with endometriosis-associated pelvic pain

A. G. Gramatikova, V. F. Bezhenar, Е. Р. Баранцевич, В А Линде, Sviatoslav Yu. Kruglov, Daria S. Kochergina-Strukova, Ilarion A. Barnash
In: Russian Military Medical Academy Reports · 2026 · vol. 45(2) , pp. 187–196 · doi:10.17816/rmmar691739 · W7172311172
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Abstract

Background: The most severe form of endometriosis is deep infiltrating endometriosis. Pain is one of its leading clinical features. The main treatment for deep infiltrating endometriosis is surgery, followed by hormone-modulating therapy postoperatively. However, this does not always provide sustained relief of chronic pain. AIM: To evaluate the efficacy of reflexology in postoperative rehabilitation of patients with chronic pain associated with deep infiltrating endometriosis. METHODS: We examined and treated 36 patients with deep infiltrating endometriosis whose main preoperative symptoms were chronic pain (dysmenorrhea, intermenstrual pain, and dyspareunia) and reduced quality of life, which persisted to varying degrees by day 45 after surgery. Pain was assessed using the Visual Analogue Scale and the McGill Pain Questionnaire. Quality of life was assessed using the N.E. Vodopyanova Scale. Patients were tested before surgery and on day 45 postoperatively. For the reflexology evaluation, participants were randomized using a random number generator (even numbers: main group; odd numbers: comparison group). The main group (n = 20) received a 12-day course of reflexology with dydrogesterone. The comparison group (n = 16) received dydrogesterone plus nimesulide. RESULTS: All patients in the main group tolerated reflexology well; no complications or adverse events occurred. At the end of treatment, both groups showed marked improvement. To assess durability, all parameters were measured 30 days later. Chronic pain partially recurred in the comparison group, whereas the main group maintained sustained improvement. Quality of life (N.E. Vodopyanova Scale) improved significantly only in the main group. The quality of life index improved in both groups, but significantly more in the main group. CONCLUSION: Reflexology using the proposed protocol is an effective component of comprehensive rehabilitation for patients with endometriosis-associated pelvic pain after surgery for deep infiltrating endometriosis.

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