Endometriosis is a chronic and often debilitating condition affecting many women. Characterised by the growth of tissue similar to the uterine lining outside the uterus, it leads to widespread physical symptoms like severe pain and fatigue. The effects can extend beyond reproductive organs, impacting surrounding tissues, nerves, and muscles. While traditionally managed through medication and surgery, physiotherapy has emerged as a non-invasive approach to help women alleviate physical discomfort and regain control over their bodies. However, the emotional toll of living with a chronic pain condition like endometriosis is equally significant, underscoring the importance of mental health support. Combining both physical and psychological care can offer a more comprehensive approach to managing the condition.
Living with chronic pain demands considerable emotional resilience, particularly when symptoms are often misunderstood or stigmatised. Many women with endometriosis experience the need to repeatedly explain or justify their pain, which can lead to feelings of isolation and embarrassment. This struggle is compounded when pain interferes with daily activities, straining relationships, work-life, and even a sense of self. The stigma surrounding reproductive health further exacerbates these challenges, causing some women to downplay or ignore their suffering.
Endometriosis also sets off a cycle between pain and mental well-being. Persistent, intense pain often triggers feelings of hopelessness, anxiety, and depression, which in turn amplify the experience of pain, making it harder to cope. Over time, this can lead to withdrawal from activities once enjoyed. As mental health deteriorates, it further impacts how individuals manage their physical condition. The psychological toll of this disease should not be underestimated, as it directly affects self-esteem, body image, and overall mental health.
"Chronic pain, such as that experienced with endometriosis, can create a cycle of pain and psychological distress. Evidence shows that depression and anxiety can exacerbate pain perception, making management more challenging. Therefore, it's crucial to address both the emotional and physical aspects simultaneously to break this cycle. Improving pain tolerance, building confidence and a sense of self, emotional regulation and helping women build resilience in the face of chronic pain can generate global benefits for people beyond their pain experience. We support people not just to manage pain, but to thrive and feel good about themselves again." — Dr. Annemarie O'Connor, Clinical Psychologist and Chief Innovation Officer at HelloSelf.
A hallmark symptom of endometriosis is pelvic pain, which ranges from mild discomfort to severe chronic pain. For women experiencing these symptoms, pelvic health physiotherapists are skilled in evaluating and addressing pelvic floor dysfunction. Chronic pelvic pain can lead to muscle tension and overactivity, which further aggravates the pain. Techniques such as manual therapy, myofascial release, and specific pelvic floor exercises can help ease muscle tension, reduce discomfort, and improve functionality in the pelvic region. Reducing this physical pain can also relieve anxiety and restore a sense of control over one’s body.
The inflammation and adhesions caused by endometriosis often result in stiffness and limited mobility in the pelvic area, hips, and lower back. Physiotherapy targets these restrictions through stretching, joint mobilisations, and soft tissue techniques, helping restore flexibility and ease movement. Personalised exercise programs designed by physiotherapists enable women to regain their independence and improve their overall well-being.
However, managing physical activity when in pain requires careful pacing. Fatigue and frustration can make it difficult to stay consistent with treatment. Pelvic Health Physiotherapists often collaborate with mental health professionals to develop manageable, long-term plans that focus on breaking down tasks into smaller, achievable steps. This approach encourages women to engage in activities when they feel energetic, reducing the likelihood of burnout and hopelessness.
Many women with endometriosis also suffer from lower back and abdominal pain due to the proximity of the endometrial lesions to the spine and abdominal muscles. Back pain physiotherapy offers targeted treatments, including manual therapy and core strengthening exercises, which help alleviate these symptoms. Strengthening the core not only relieves strain on the lower back but also supports surrounding muscles, easing the discomfort in these areas. Reducing pain in this way also improves emotional resilience, helping break the pain-mental distress cycle.
Endometriosis often leads to poor posture, which can cause compensatory movement patterns that trigger discomfort in other parts of the body, such as the shoulders, neck, and hips. Physiotherapists assess these postural imbalances and work to correct them, ensuring optimal body alignment and function. Postural re-education and ergonomic advice enable women to perform daily tasks with less strain, ultimately reducing the recurrence of pain.
Addressing posture also extends to body image and identity. Many women with endometriosis struggle with feeling "different" due to pain or bloating, which may affect their ability to engage in activities or even wear the clothes they want. Tackling these emotional challenges can be as crucial as treating the physical imbalances.
Exercise plays a vital role in managing endometriosis long-term, but for many women, physical activity can be overwhelming due to pain and fatigue. Physiotherapists create customised, low-impact exercise programs that focus on pain-free movements such as gentle stretching, yoga, and strengthening exercises. Building strength and endurance over time helps increase energy levels while reducing pain episodes.
Consistency with exercise is often a challenge, particularly when mental health or fatigue comes into play. In these instances, collaboration between physiotherapists and mental health professionals is key. By addressing psychological barriers like low motivation or anxiety, and incorporating fatigue management strategies, women are more likely to stick to their treatment plans, leading to improvements in both physical and emotional well-being.
Endometriosis affects both the body and the mind, necessitating a holistic treatment approach. Physiotherapy addresses the physical aspects of the condition by improving mobility, reducing pain, and restoring functionality. Simultaneously, mental health support provides women with the psychological tools needed to cope with the emotional burden of living with chronic pain. By working together, physiotherapists and mental health professionals offer a personalised, comprehensive care plan that promotes healing on both physical and emotional levels.
If you are facing the challenges of endometriosis, remember that you are not alone. The partnership between HelloSelf and Excellence Physiotherapy offers a holistic solution that addresses both the physical and emotional dimensions of the condition, helping you regain control and lead a healthier, more fulfilling life.
For more information or to Contact Excellence Physiotherapy:
You can visit www.excellencephysiotherapy.com or Call them directly on 0207 125 0262
