The 10% Club: Endometriosis Matters in Low Back Pain

Overview

Endometriosis affects approximately 10% of all people with a uterus, making it one of the most prevalent gynecological conditions in clinical practice. Yet it remains chronically under-identified, particularly in physiotherapy settings, where its most common symptoms (painful periods, pain with intercourse, and low back pain that worsens during menstruation) are frequently attributed to musculoskeletal causes alone. The result is that many patients spend years in care without their underlying condition being recognized or addressed.

This course is the second in the Weird and Wonderful Strategies that EVERY Physio Should Know to Effectively Treat LBP series, hosted by Carolyn Vandyken in collaboration with Embodia. In this installment, pelvic health physiotherapist Jill Mueller takes clinicians through the often-missed relationship between endometriosis and low back pain, and equips them with practical tools to screen for it and treat it from a whole-person, biopsychosocial framework. Individual courses in this series can be purchased separately, or you can register for the full series at a discount.

Learning Objectives

By the end of this course, participants will be able to:

1. Describe the connection between low back pain and endometriosis, and explain why endometriosis is frequently misidentified as a musculoskeletal problem.
   
   
2. Apply a sensitive, history-taking approach that screens for endometriosis in patients presenting with low back pain.
   
   
3. Identify the dominant source of endometriosis-associated pain using a phenotype-informed assessment framework.
   
   
4. Apply biopsychosocial treatment strategies for patients with endometriosis-associated low back pain, including pain reprocessing therapy, somato-cognitive therapy, and the 5 P's framework.
   
   
5. Integrate a "working out and working in" approach that addresses both physical and nervous system contributors to pain.

Audience

This course is designed for physiotherapists and pelvic health clinicians who regularly treat patients with persistent low back pain and want to ensure they are not missing endometriosis as a contributing or driving factor. It is also relevant for pelvic OTs and any rehabilitation clinician working with people assigned female at birth who present with complex, multi-system pain.

No prior knowledge of endometriosis is required. This course is accessible to generalist physiotherapists as well as those with existing pelvic health experience.

Why This Course Matters

Low back pain and endometriosis share a clinical overlap that is easy to miss and costly to overlook. Patients with unidentified endometriosis often cycle through musculoskeletal treatment without meaningful improvement — not because the treatment is wrong, but because the full clinical picture is incomplete. By learning to recognize the symptom patterns that point toward endometriosis and adopting a biopsychosocial lens, clinicians can significantly change the trajectory of care for this population.

This course also addresses something that goes beyond assessment: how to treat. Drawing on current pain science, somato-cognitive therapy, and pain reprocessing approaches, Jill Mueller shows clinicians how to address the sensitized nervous system that underlies much of the pain in endometriosis — not just the tissue. For patients who have spent years feeling dismissed or misunderstood, this shift in clinical approach can be genuinely transformative.