Advocacy and Research

How can I manage my endometriosis-related pain?

Whether you are newly diagnosed or have been living with endometriosis for many years, you may find yourself asking, “Is there anything else I can do to help with the pain?†While there are many medical and surgical options available, a lot of women are not fully satisfied with their pain reduction. In honor of Endometriosis Awareness Month, and every month, we’re here to help.

Endometriosis is the name given to a condition in which endometrial tissue (the lining of your uterus) grows in places outside of the uterus. The growth of endometrial tissue outside of the uterus can cause areas of restricted or “stuck†tissue called adhesions. Adhesions and scar tissue from surgeries to treat endometriosis, as well as endometrial implants themselves, can cause constipation, painful sex, and severe pain, which worsens during your period. Pain or irritation from endometrial implants on a pelvic organ may refer or appear in muscles that are innervated by the same spinal level as the irritated organ. This is known as the viscerosomatic reflex and can result in muscle spasms and trigger points, which may seem completely unrelated to endometriosis. Scientists still do not agree on a definitive cause of endometriosis; however, scientists have recently published many studies about steps individuals can take to help with their endometrial pain. Getting in daily exercise has been shown to be helpful in alleviating and preventing many health conditions. The benefits of exercise on endometriosis-related pain have been reviewed in an article by Bonocher(2) and colleagues. The authors of this review found that exercise may indeed have a preventative effect on the development of endometriosis in women who exercised between two and four hours a week. The same article also suggests exercise may help women who are already suffering from endometriosis-related pain. The pain caused by endometriosis is thought to occur because of inflammation caused by endometrial implants outside of the uterus. Exercise had been shown in repeated studies to increase anti-inflammatory chemicals in the blood and therefore reduce pain caused by inflammatory processes. In a study by Zahra Rakhshaee(4), published in 2011, yoga was found to ease painful periods and may be helpful in managing the symptoms of endometriosis. In this study, a yoga routine consisting of daily 20-minute sessions had a significant effect in reducing pain in the study participants. Acupuncture is an ancient Chinese healing practice and can be used to treat many conditions. In a review by Leong in 2014 (3), acupuncture reduced painful periods in 92% of study participants. The review also cited an article in which 73% of participants reported an improvement in their symptoms versus 42% receiving a placebo (fake) treatment. Physical therapy treatment can be helpful in treating many of the issues associated with endometriosis. In a study by Wurn in 2011 (5), physical therapy was shown to have a significant effect on reducing pain and improving sexual function in women who have endometriosis. Physical therapists are trained healthcare practitioners who can guide you in strengthening and stretching programs to help ease your pain, apply hands-on techniques to restore mobility lost due to endometriosis and other conditions, as well as guide you through lifestyle modifications you can make to ease your pain and other pelvic floor symptoms. Physical therapy can also be helpful to mobilize and “free up†tissues that have become stuck as a result of adhesions caused by endometriosis. A physical therapist can use his or her hands to loosen adhesions to allow the organs of your abdominal cavity to move more freely, and thus reduce pain, improve issues with constipation and even make sexual intercourse more comfortable. (Arung, 2011) If one or all of these methods of pain management strategies sounds like they will work for you, Beyond Basics Physical Therapy can help guide you. We have an excellent team of physical therapy practitioners who are experts in the field of pelvic health, who do hands on work, who can develop an appropriate exercise plan tailored to your needs, and can guide you through other lifestyle modifications to help reduce your pain. We also partner with acupuncture and yoga professionals who offer services on site at our Midtown clinic. We hope to see you soon as you begin your journey of healing. Sources: 1.) Arung W, Meurisse M, Detry O. Pathology and prevention of postoperative peritoneal adhesions. World J Gastroenterol. 2011: 17(41) 4545-53 2.) Bonocher C, Montenegrow M, Rosa e Silva, et al. Endometriosis and physical exercises: a systematic review. Reproductive Biology and Endocrinology. 2014, 12:(4) 3.) Leong F. Complementary and alternative medications for chronic pelvic pain. Obstetrics and Gynecology Clinics of North America. 2014, 41:(3): 503-10 4.) Rakhshaee Z. Effect of three yoga poses (cobra, cat and fish) in women with primary dysmenorrhea: A randomized clinical trial. Journal of Pediatric Adolescent Gynecology. 2011;24(4):192-6 5.) Wurn B, Wurn L, Patterson K. Decreasing dyspareunia and dysmenorrhea in women with endometriosis via a manual therapy: results from two independent studies. 2011;3(4)

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