{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T01:20:43Z","timestamp":1792977643565,"version":"4.5.0"},"reference-count":54,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T00:00:00Z","timestamp":1610064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic pelvic pain persists in some women with endometriosis even after lesion removal and optimized hormonal treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Characterize the presence and distribution of pain, myofascial dysfunction and sensitisation beyond the pelvis in women with endometriosis\u2010associated chronic pelvic pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cross\u2010sectional study of 30 women prior to participation in a clinical trial. Evaluation included pain\u2010focused abdominopelvic gynaecologic examination with the identification of pelvic floor muscle spasm. Neuro\u2010musculoskeletal examination assessed paraspinal allodynia and hyperalgesia bilaterally and myofascial trigger points in 13 paired muscles. Pressure\u2010pain thresholds were measured over interspinous ligaments and trigger points. Women completed the body territories element of the Body Pain Index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All women had a pelvic floor muscle spasm that they self\u2010identified as a major focus of pain. Twenty of 30 women described their pelvic pain as focal. However, all demonstrated widespread myofascial dysfunction with low pressure\u2010pain thresholds and trigger points in over two\u2010thirds of 26 assessed regions. Widespread spinal segmental sensitisation was present in 17\/30, thoracic in 21\/30 and lumbosacral\/pelvic in 18\/30. Cervical sensitisation manifested as low pressure\u2010pain thresholds with 23\/30 also reporting recurrent, severe headaches and 21\/30 experiencing orofacial pain. Those reporting diffuse pelvic pain were more likely to have widespread (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.024) and lumbosacral\/pelvic (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.036) sensitisation and report over 10 painful body areas (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.009).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with endometriosis\u2010associated chronic pelvic pain often have myofascial dysfunction and sensitisation beyond the pelvic region that may be initiated or maintained by on\u2010going pelvic floor spasm. These myofascial and nervous system manifestations warrant consideration when managing pain in this population.<\/jats:p><jats:p>Clinicaltrials.gov identifier: NCT01553201.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Women with endometriosis often have pelvic pain persisting after surgery despite hormonal therapies and these women have regional pelvic sensitisation and myofascial dysfunction. Pelvic floor muscle spasm is a major pain focus in this population. Sensitisation and myofascial dysfunction are widespread, beyond the pelvic region. On\u2010going pelvic floor spasm may initiate or maintain sensitisation. Myofascial\/sensitisation manifestations warrant consideration when managing pain in this population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1713","type":"journal-article","created":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T19:32:21Z","timestamp":1608233541000},"page":"831-840","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Widespread myofascial dysfunction and sensitisation in women with endometriosis\u2010associated chronic pelvic pain: A cross\u2010sectional study"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8654-1013","authenticated-orcid":false,"given":"Vy T.","family":"Phan","sequence":"first","affiliation":[{"name":"Rehabilitation Medicine Department Clinical Center National Institutes of Health Bethesda MD 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