Pilot Study of Pelvic Girdle Pain in Women with and Without Laparoscopically Diagnosed Endometriosis

Objective: Pelvic girdle pain is a well recognized cause of back pain in the pregnant and postpartum population. In this pilot study, we explore whether pelvic girdle pain is also involved in the etiology of back pain outside the pregnant/postpartum period, in women with or without laparoscopically diagnosed endometriosis. Methods: Retrospective review of new patients seen for pelvic pain from June – December 2012 at a tertiary referral centre. Patients self-rated back pain severity from 0-10. Pelvic girdle pain tests were sacroiliac dorsal ligament tenderness, right or left active straight leg raise, and right or left Faber tests. The examiner was blinded to the back pain severity. Pelvic girdle pain was tested for an association with the severity of back pain. Endometriosis was diagnosed on laparoscopy, and the presence or absence of endometriosis was also considered. Results: Sixty-three women with pelvic pain met the study criteria, with 82% having underlying endometriosis (32/39). Pelvic girdle pain (presence of at least one positive pelvic girdle pain test) was significantly associated with greater severity of back pain (5.6 +/2.9 vs. 3.5 +/- 2.9, Mann-Whitney test, p=0.009). Furthermore, the number of positive pelvic girdle pain tests was significantly associated with the severity of back pain (Spearman rho=0.30, p=0.016; linear regression b=0.53, p=0.031). Pelvic girdle pain was similarly present in women with or without endometriosis (63% (20/32) vs. 86% (6/7), Fisher Exact test, p=0.39). No other demographic variables, diagnoses, symptoms, or signs, were associated with severity of back pain. Conclusion: This pilot study provides initial evidence that pelvic girdle pain is involved in the etiology of back pain in the pelvic pain population, similar to the pregnant/postpartum population, in women with or without endometriosis at laparoscopy.