Effectiveness of physiotherapy interventions for the treatment of chronic pelvic pain in women: a systematic review and meta-analysis

Chak Yung Choa, Yuya Guo, Gurwant Kaur, PRIYA KANNAN, Crystal Kwan
Purpose:

To evaluate the effectiveness of physiotherapy interventions for improving pain and quality of life (QoL) among people with CPP.

Methods:

Electronic searches were conducted in multiple English and two Chinese databases from inception to February 2024. Adult men and women with CPP were included in this review. Randomised controlled trials (RCTs) evaluating the effectiveness of physiotherapy interventions or acupuncture were considered for inclusion in this review. RCTs published in languages other than English and Chinese were excluded from the review. The Cochrane risk of bias tool was utilised to evaluate the risk of bias in the included studies. Data analysis was performed using the Comprehensive Meta-Analysis software (V.2). 

Results:

Twenty-eight trials met the eligibility criteria and were included in the review. Meta-analysis revealed a significant effect for acupuncture (SMD 0.50, 95% CI 0.33 to 0.68, p = 0.000) and biofeedback combined with pelvic floor muscle training (PFMT; standardised mean difference (SMD) 1.03 [95% CI 0.40 to 1.65, p = 0.001]) in improving QoL compared with the control condition. Meta-analysis revealed that electrical stimulation (ES) was significantly better than the control condition in improving CPP (SMD 5.12 [95% CI 3.70 - 6.50, p = 0.000]). Electroacupuncture (EA) was found to have no significant effects on QoL (SMD 1.16, [95% CI 0.94 to 3.25, p = 0.279]) and pain severity (SMD 2.49, 95% CI 0.36 to 5.33, p = 0.087) among people with CPP.

Conclusion(s):

Conclusion(s): ES is beneficial for improving pain severity among people with CPP. Biofeedback combined with PFMT and acupuncture improves QoL among people with CPP. The benefits of EA on pain and QoL of people with CPP remain inconclusive.

Implications:

1. Acupuncture and biofeedback combined with PFMT can improve QoL among people with CPP.

2. ES is beneficial for improving pain severity in people with CPP.

3. Acupuncture and biofeedback are low-risk interventions; therefore, these interventions should be considered in clinical settings to improve QoL in people with CPP.

Funding acknowledgements:
Dean’s Reserve, Faculty of Health and Social Sciences (Ref No.: 1-ZVX9), Hong Kong Polytechnic University.
Keywords:
Chronic Pelvic Pain
Biofeedback
Pelvic Floor Muscle Training
Primary topic:
Women's health
Second topic:
Pain and pain management
Third topic:
Pelvic, sexual and reproductive health
Did this work require ethics approval?:
No
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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