• Ana Lara-Ramos, Francisco Álvarez-Salvago, Carolina Fernández-Lao, Noelia Galiano-Castillo, Olga Ocón-Hernández, Maryna Mazheika, Ma Mar Salinas-Asensio, Antonio Mundo-López, Manuel Arroyo-Morales, Irene Cantarero-Villanueva, and Francisco Artacho-Cordón.
• Gynaecology and Obstetrics Unit, 'Virgen de las Nieves' University Hospital, Granada, Spain.
• Pain Med. 2021 Sep 8; 22 (9): 1970-1981.

ObjectiveTo explore hypersensitivity to pain and musculoskeletal impairments in the lumbopelvic area in women with and without endometriosis.MethodsThis 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.ResultsWomen 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.ConclusionsThe 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.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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