Evaluation of the effectiveness of rehabilitation treatment in patients with chronic pelvic pain: a systematic review

Introduction: Chronic pelvic pain refers to persistent or recurrent pain, perceived in the structures related to the male or female pelvis. Because of its complex aetiology, there is no one therapy that can be recommended, but guidelines propose a multimodal treatment approach that makes use of the skills of various health figures, including physiotherapists. Aim: To evaluate the effectiveness of rehabilitation treatment in patients suffering from CPP, in terms of reducing pain symptoms, improving the quality of life and addressing associated psychological symptoms. Materials and Methods: A systematic review was conducted using the online databases Pubmed, PEDro and Cochrane, including only RCTs in English with full-text availability, concerning rehabilitation treatment in subjects with CPP. The methodological quality of each article was evaluated using the PEDro Scale, and the risk of bias using Cochrane collaboration’s tools for assessing risk of bias. Results: Of the 996 studies analysed, only 10 articles (420 participants) met the inclusion criteria. In all of the studies, when compared with baseline, post treatment outcomes showed significant reduction in pain symptoms. The same result was obtained with respect to quality of life and psychological symptoms, where these were examined (5/10). A comparison of treatments failed to show a statistically significant superiority of physiotherapy intervention. Conclusions: The small number of studies and the critical internal methodological issues identified, make it impossible to reach definitive conclusions. New RCTs are therefore needed to validate the effectiveness of rehabilitation treatment in patients with CPP.