Versailles - 78000

Place of manual therapy in patients with endometriosis: Review of the scope - Conclusion and references

5. Conclusion

Many different types of treatment (physical, psychotherapeutic, manual, etc.) have been tried for endometriosis. Unfortunately, none has proved curative. They help to improve symptoms and patients' quality of life. And this study proves that manual therapies are an additional aid in the multidisciplinary treatment of patients.

Over the past decade, there has been a real increase in the diagnosis of endometriosis. However, patients are still rarely referred for manual treatment. This is partly due to the fact that some therapists feel limited in their treatment, as they do not have sufficient knowledge of this pathology. However, it is recommended that manual therapists, including osteopaths, be given more training in the management of patients with endometriosis. Students should also be given more detailed explanations of the disease and how to care for patients. After all, these women need moral support, explanations of their condition, answers to their questions, etc. In addition to the theoretical part of the pathology, practical courses could point students in the direction of possible treatments for patients, bearing in mind that several techniques have already shown improvements in previous studies. Of course, we mustn't forget that osteopathy is "patient-centred", and that there is no such thing as an identical treatment protocol for the same reason for consultation.

Consequently, the therapeutic approach to a woman with endometriosis should be individualized, offering her the best treatment options, according to the symptoms and problems that afflict her, and taking into account her preferences and priorities. In this way, patients' needs must be carefully considered as part of medical advice. And women must be offered a more active role in shaping their own treatment strategy. This means giving them advice, such as practising sport (particularly muscle strengthening, pilates and yoga), which helps to relieve the discomforts of endometriosis. Above all, it's important that the sporting activity is good for the patient. No sport should be totally banned in cases of endometriosis. Diet is another point on which patients can intervene. It is recommended that they cut down as much as possible on pro-inflammatory foods (alcohol, sugar, red meat, etc.) and favor anti-inflammatory foods such as fruit, vegetables, oily fish, etc., to reduce the inflammation created by endometriosis. Giving patients advice helps them learn to live better with their condition, and empowers them.

6. References

  1. Haute Autorité de Santé. Prise en charge de l'endométriose : Méthode Recommandations pour la pratique clinique. Collège de la Haute Autorité de Santé 2017

  2. Vercellini P, Viganò P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014 May;10(5):261-75.

  3. Bolze PA, et al, Contribution of the multidisciplinary concentration meeting to the appropriateness of the diagnosis and treatment of endometriosis. Gynecology Obstetrics Fertility & Senology 2018

  4. Pospisilova E, et al. Circulating Endometrial Cells: A New Source of Information on Endometriosis Dynamics. Journal of Clinical Medicine 2019;8:1938

  5. World Health Organization (WHO), "Key facts about endometriosis", March 31, 2021 / Available at: https://www.who.int/fr/news-room/fact-sheets/detail/ endometriosis / Accessed on: December 14, 2021

  6. Burney R, et al. Pathogenesis and physiopathology of endometriosis. Fertility and Sterility 2012;3(98):511-519

  7. Borghese B, et al. Definition, description, anatomo-clinical forms, pathogenesis and natural history of endometriosis, RPC Endometriosis CNGOF-HAS. Gynecological Obstetrics Fertility & Senology 2018

  8. H.S. Taylor, L.C. Giudice, B.A. Lessey, M.S. Abrao, J. Kotarski, D.F. Archer, M.P. Diamond, E. Surrey, N.P. Johnson, N.B. Watts, J.C. Gallagher, J.A. Simon, B.R. Carr, W.P. Dmowski, N. Leyland, J.P. Rowan, W.R. Duan, J. Ng, B. Schwefel, J.W. Thomas, R.I. Jain, and Chwalisz K. Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist. N Engl J Med 2017; 377:28-40

  9. Jackson B, Telner D. Managing the misplaced: approach to endometriosis. Canadian Family Physician 2006;52:1420-1424

  10. Wattier J-M. Antalgiques et alternatives thérapeutiques non médicamenteuses pluridisciplinaires, RPC Endometriose CNGOF-HAS. Gynecology Obstetrics Fertility & Senology 2018;3(46):248-255

  11. Golfier F, Chanavaz-Lacheray I, Descamps P, Agostini A, Poilblanc M, Rousset P, Bolze PA, Panel P, Collinet P, Hebert T, Graesslin O, Martigny H, Brun JL, Déchaud H, de Malartic CM, Piechon L, Wattiez A, Chapron C, Daraï E. The definition of Endometriosis Expert Centres. J Gynecol Obstet Hum Reprod. 2018 May;47(5):179-181.

  12. Falcone T, Flyckt R. Clinical Management of Endometriosis. Obstet Gynecol. 2018


  13. Haute Autorité de Santé. Étude documentaire sur les professions d'ostéopathe et de

    chiropractor in Europe: Belgium, United Kingdom, Sweden, Switzerland. Collège de la Haute

    French Health Authority 2006

  14. Direction générale de la concurrence, de la consommation et de la répression des fraudes,

    "Médecines non conventionnelles", December 18, 2019 / Available at: https:// www.economie.gouv.fr/dgccrf/Publications/Vie-pratique/Fiches-pratiques/medecines- non-conventionnelles Accessed on: December 6, 2022

  15. World Health Organization. Benchmarks for training in traditional / complementary and alternative medicine : benchmarks for training in osteopathy 2010

  16. Sillem M, Juhasz-Böss I, Klausmeier I, Mechsner S, Siedentopf F, Solomayer E. Osteopathy for Endometriosis and Chronic Pelvic Pain - a Pilot Study. Geburtshilfe Frauenheilkd. 22 Sep 2016;76(09):960-3.

  17. Agence nationale d'accréditation et d'évaluation en santé, editor. Analysis of the literature and gradation of recommendations: January 2000. Paris: Agence nationale d'accréditation et d'évaluation en santé; 2000.

  18. Goyal K, Goyal M, Narkeesh K, John Samuel A, Sharma S, Chatterjee S, et al. The effectiveness of osteopathic manipulative treatment in an abnormal uterine bleeding related pain and health related quality of life (HR-QoL) - A case report. Journal of Bodywork and Movement Therapies. july 2017;21(3):569-73.

  19. Darai C, Deboute O, Zacharopoulou C, Laas E, Canlorbe G, Belghiti J, et al. Impact of osteopathic manipulative therapy on quality of life of patients with deep infiltrating endometriosis with colorectal involvement: results of a pilot study. European Journal of Obstetrics & Gynecology and Reproductive Biology. may 2015;188:70-3.

  20. Daraï C, Bendifallah S, Foulot H, Ballester M, Chabbert-Buffet N, Daraï E. Clinical benefit of osteopathic treatment in patients with colorectal endometriosis: classification based on symptoms and quality of life. Gynecology Obstetrics Fertility & Senology. sept 2017;45(9):472-7.

  21. Bourdel N, Comptour A, Chauvet P, Canis M. Douleurs et endométriose. Douleurs : Évaluation - Diagnostic - Traitement. Feb 2020;21(1):3-10.

  22. Allaire C, Long AJ, Bedaiwy MA, Yong PJ. Interdisciplinary Teams in Endometriosis Care. Semin Reprod Med. May 2020;38(02/03):227-34.

  23. Friggi Sebe Petrelluzzi K, Garcia MC, Petta CA, Ribeiro DA, de Oliveira Monteiro NR, Céspedes IC, et al. Physical therapy and psychological intervention normalize cortisol levels and improve vitality in women with endometriosis. Journal of Psychosomatic Obstetrics & Gynecology. Dec 1, 2012;33(4):191-8.

  24. Buggio L, Barbara G, Facchin F, Frattaruolo MP, Aimi G, Berlanda N. Self-management and psychological-sexological interventions in patients with endometriosis: strategies, outcomes, and integration into clinical care. IJWH. May 2017;Volume 9:281-93.

  25. Agarwal S, Foster WG, Groessl E. Rethinking endometriosis care: applying the chronic care model via a multidisciplinary program for the care of women with endometriosis. IJWH. Jul 2019;Volume 11:405-10.

  26. Schwartz ASK, Gross E, Geraedts K, Rauchfuss M, Wölfler MM, Häberlin F, et al. The use of home remedies and complementary health approaches in endometriosis. Reproductive BioMedicine Online. Feb 2019;38(2):260-71.

  27. Heller GZ, Manuguerra M, Chow R. How to analyze the visual analog scale: myths, truths, and clinical relevance. Scand J Pain. 2016 Oct; 13:67-75

  28. DE, Wasiak R, Kreif N, Raluy M, Colligs A, Seitz C, Gerlinger C. Validation of the SF-36 in patients with endometriosis. Qual Life Res. 2014 Feb;23(1):103-17

  29. Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, Westlake L. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992 Jul 18;305(6846):160-4 ; 10.1136

  30. Service Public d'Information en Santé, "Évaluer la qualité de vie en cas d'endométriose", May 24, 2022 / Available at: https://www.sante.fr/endometriose/ evaluer-la-qualite-de-vie-en-cas-dendometriose Accessed on: February 8, 2023

  31. Grundström H, Rauden A, Wikman P, Olovsson M. Psychometric evaluation of the Swedish version of the 30-point endometriosis health profile (EHP-30). BMC Womens Health. 2020 Sep 14;20(1):204 ;10.1186/s12905-020-01067-6

  32. Le Ministère des Solidarités et de la Santé, Gouvernement.fr, Haute Autorité de Santé, ENDOmind, EndoFrance, Resendo, Inserm, "Soigner l'endométriose et vivre avec la maladie", March 4, 2022 / Available at: https://www.sante.fr/soigner-lendometriose-et- vivre-avec-la-maladie Accessed on: February 10, 2023

  33. Salmon M, Cretal A, Gonzales-Bandres M. Should person-centredness care be an affordable goal in French osteopathic education? International Journal of Osteopathic Medicine. March 2022;43:1-4.

  34. Steel A, Foley H, Redmond R. Person-centred care and traditional philosophies in the evolution of osteopathic models and theoretical frameworks: Response to Esteves et al. International Journal of Osteopathic Medicine. June 2020;36:60-1.

  35. Anderson JG, Taylor AG. Effects of healing touch in clinical practice: a systematic review of randomized clinical trials. J Holist Nurs. 2011 Sep;29(3):221-8.

  36. M, Sujianto U, Johan A. Effects of Therapeutic Touch to Reduce Anxiety As a Complementary Therapy: A Systematic Review. KLS. Oct 9, 2019

  37. Bagci H, Yucel SC, Bagcı H. A Systematic Review of the Studies about Therapeutic Touch after the Year of 2000.

  38. Kane GC, Gotto JL, Mangione S, West S, Hojat M. Jefferson Scale of Patient's Perceptions of Physician Empathy: preliminary psychometric data. Croat Med J. Feb 2007;48(1):81-6.

  39. DiMatteo MA. A social-psychological analysis of physician-patient rapport: toward a science of the art of medicine. J Soc Issues. 1979;35:12-33.

  40. Neuwirth ZE. Physician empathy: Should we care? Lancet. 1997;350:606

  41. EndoFrance, "The urinary manifestations of endometriosis", March 5, 2020 / Available at: https://www.sante.fr/endometriose/evaluer-la-qualite-de-vie-en-cas-

    dendometriosis Accessed on: February 23, 2023

  42. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, McInerney P,

    Godfrey CM, Khalil H. Updated methodological guidance for the conduct of scoping

    reviews. JBI Evid Synth. 2020 Oct;18(10):2119-2126.

  43. Pannucci CJ, Wilkins EG. Identifying and Avoiding Bias in Research: Plastic and

    Reconstructive Surgery. August 2010;126(2):619-25.

  44. Noll DR, Degenhardt BF, Stuart M, McGovern R, Matteson M. Efficacy of a sham protocol and adverse effects in a clinical trial of osteopathic manipulative treatment in nursing home patients. J'ai l'ostéopathe associé. 2004 March;104(3):107-13.

  45. Fulda KG, Slicho T, Stoll ST. Patient expectations for placebo treatments commonly used in osteopathic manipulative treatment (OMT) clinical trials: a pilot study. Osteopath Med Prim Care. 12 Jan 2007;1:3.

  46. Bialosky JE, Bishop MD, Penza CW. Placebo Mechanisms of Manual Therapy: A Sheep in Wolf's Clothing? J Orthop Sports Phys Ther. May 2017;47(5):301-4.

Athina De Vogel
Osteopath D.O
2 rue Alexis de Tocqueville
78000 Versailles

Athina De Vogel osteopath versailles

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