How can physiotherapy reduce the pain of endometriosis?

In collaboration with Major Mouvement, Kinesitherapist

Endometriosis is a female gynecological disease characterized by an inflammatory condition caused by endometrial-like tissue migrating out of the uterus. The disease can take several forms: cystic endometriosis, infiltrated endometriosis or adenomyosis. Endometriosis causes pain that is difficult to reduce.

Endometriosis can cause severe pain that can limit schooling or work. This pain is often poorly controlled by medication. The pain and symptoms resulting from endometriosis are different from one woman to another, as each woman has her own endometriosis. However, pain occurs mainly during periods, at ovulation, but also during intercourse: this is known as dyspareunia. Another sign that may hide endometriosis is the fact of having abundant periods . 

The problem with endometriosis is that, as well as causing disabling pain on a daily basis, the diagnosis of this disease is extremely complicated. In fact, the average time taken to diagnose this disease is around 7 years. 7 years during which patients find themselves in a state of total medical vagrancy. In some cases, the disease is even discovered during surgery, as imaging may not match the clinical picture.  

Although there is currently no cure for endometriosis, the pain associated with this condition can sometimes be relieved by physiotherapy or osteopathy. Through massage, mobilization and movement, and by listening to the patient's needs, we can help to alleviate and learn to manage pain. 

How can I reduce pain with physiotherapy?

The physiotherapist can act both externally and internally, through massage, mobilization, postural re-education, physiotherapy, respiratory re-education etc...

Several techniques are available: 

• Abdominal and respiratory work: because of pain, patients tend to block themselves. The aim of abdominal and respiratory physiotherapy is to restore breathing, relax and manage pain, and gently stretch sensitive areas. The physiotherapist can first concentrate on the whole abdomen, then on the diaphragm, and finally do visceral work on the visceral fascias, listening to the patient and the tissues that relax during movement. The most important thing is to listen to the patient and her pain, because every endometriosis is different, and so are the pains.

• The physiotherapist can help reduce pain during intercourse (dyspareunia): by learning to relax the perineum, and beyond the perineum, by concentrating on relaxing the muscles of the vagina, as endometriosis can create adhesions which, by limiting tissue mobility, make intercourse painful. The aim is to restore tissue mobility. 

The idea is to promote adapted physical activity that will benefit the patient both physically and mentally, followed by treatment of the pain itself: how to manage pain and relieve it on a daily basis. 

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